Dr Renee White: [00:00:00] Knowledge is power and we are all about empowering the mamas of the world. In each episode we will unravel and interpret the latest research and evidence based practices for pregnancy, postpartum and motherhood. As mums and researchers ourselves we have experienced firsthand the overwhelming complexity of information, myths and those classic old wives tales.

I'm Dr Renee White and this is The Science of Motherhood. Hello and welcome to episode 166 of The Science of Motherhood, I am your host, Dr. Renee White. Thank you so much for joining me today. This is episode three of our miniseries on perimenopause slash menopause and it's our final episode in the miniseries.

It is a absolute cracker for so many different reasons. And you, I, first of all, I need to say thank you to you [00:01:00] all for sending in your questions for our guests. I did a shout out on Instagram and we received so many questions and obviously like there was only a number of them we you could get through in this episode, but I kind of collated similar themes with that.

So I just wanted to say a big shout out. Thank you. Thank you. Thank you. I also wanted to do a little happy dance celebration. It is four years almost to the day that we aired our very first episode on this podcast. So I'm gonna, I'm just going to give myself a clap. Four years of just smashing out episodes.

Now, in the beginning, we were a little bit ad hoc. We were a little bit, uh, uh, okay. Um, how do we do this? [00:02:00] And how do we navigate that? Um, I was editing the podcast myself, which I can tell you right now was, uh, a skillset that I no longer want to actually flex. So I quickly found a podcast editor, so a big shout out to Jono, who edits all of our podcasts.

He has been with us for quite some time. So thank you, thank you, thank you Jono, you do an excellent job. Especially when I stuff up and I use the wrong, um, microphone, not my professional one. Or sometimes I don't click the right button and it goes through my laptop. So, um, he weaves his magic and does the best he can to fix those things.

But yes, four years has been quite, quite an interesting process and I forget what it was. It must be like just over a year ago. I kind of said to myself, [00:03:00] I'm going to do this on the weekly. We are going to smash this out and have something every single week and I'm so proud of what this podcast has achieved and I'm, if you, if you don't already know my method to the madness, I've record these well, well in advance. So at the mument in real time, it is December 2024. And I know this is going to be aired in March 2025. So at this point in time, we've got over 85. thousand downloads. I'm curious to know what it's going to be in March when this finally airs, but it's going to be very exciting.

Nevertheless, we've had some amazing guests on this podcast, the likes of, you know, Eve Rodsky, who is a New York Times bestseller. We've had people like Dr. Greer Kirshenbaum, who is a world renowned neuroscientist. [00:04:00] We have had Lily Nichols, who is literally the queen of pregnancy and postpartum nutrition.

I also want to give a shout out to the people who, uh, turn up on the regular, the people who, um, have been on our podcast many, many times, Dr. Stephanie Pirotta, who is the guru of endometriosis and PCOS and nutrition when it comes to those types of things. We also have the amazing Dr. Cheryl Phua, who's been part of this Menopause, Perimenopause mini series.

She's come on a number of times. So yes, people who are on the regular here at the Science of Motherhood, I just wanted to give a very big shout out. And equally to those people who've only featured once and who've just literally bought their A game, I have learned so much from all of these amazing [00:05:00] individuals, this is almost like a little guilty pleasure for me to turn up and chat to people about really interesting topics and it's kind of like as the cream and cherry on top.

I get to share it with you. So thank you for joining us for the past four years. I hope we have another four years, at least, in the tank to go. But who knows what this podcast will evolve into. Who knows, who knows, who knows. Um, I started this in my bedroom with a laptop and like a $60 microphone and on Zoom.

And now we've got a pretty profesh set up with, I don't know, what brand it this? I'm not sure my husband set this all up for me because he was like, geez, Renee, you need to start taking this a bit more seriously because, because you're going to do this on the regular. So we've got professional camera, we've got lighting, and we've got all the [00:06:00] gadgets kind of help with making this a really nice podcast to listen to.

So, thank you everyone for listening in for the past four years. All right, let's dive into today's episode. As I said, it is number three in our perimenopause menopause little mini series that I've been doing. And we have got a fantastic guest. Her name is Dr. Shauna Watts. She's a family doctor. She's a business owner, but she has got a really special interest in menopause and aesthetic medicine.

Um, she's also a mum of four, um, she's a keynote speaker. She's the host of her Australian medical podcast, All About You with Dr. Shauna Watts and you will be able to tell from her accent pretty quickly. She is from Northern Ireland and she immigrated from there to Australia about a decade ago. She's got over 20 years of experience in medicine.

Um, she started, um, [00:07:00] in surgery before training to become a GP and she just loves helping women in particular with anything to do with hormones. So, you know, perimenopause, menopause, obviously her focus is not just about that. It's about body and skin and brain and libido and all the hormonal changes that occur.

And so she takes a really holistic approach, which I love. You will hear this time and time again. Over the past four years, I am all about people who take a holistic approach to health because we are not, um, you know, as a human being, it's like, you know, doing an experiment in a test tube. Yes, it might work in a test tube, but once you put it into a human or some other kind of really complex network and function, there's other things at play guys.

And so you really need to think about it as a whole picture, not just a siloed [00:08:00] little experiment. You'll hear in the podcast, I met Shauna at a recent workshop here in Hobart, where she was the keynote speaker talking about perimenopause and menopause. And I was like, I need to get this woman on the podcast stat. Me and my girlfriends were just sitting there going.

Oh my god, this woman is absolutely amazing. So in today's podcast we are looking at what perimenopause is, what menopause is, how are they different, some really interesting ongoing and new research in the area when it comes to these two topics. And then I just unleash huge rapid fire on Dr. Shauna Watts.

She goes through some of the questions that you, as the listeners, have put towards her. And they are great questions, guys. Well done. They were [00:09:00] so, so good. So get your pen and paper ready because here is Dr. Shauna Watts. Hello and welcome to the podcast, Dr. Shauna Watts. How are you today?

Dr Shauna Watts: I am good. Thank you. Thank you so much for inviting me. I'm really delighted to be here.

Dr Renee White: Oh, my pleasure. Now, for all those playing at home, you would have heard from the introduction that I came across Dr Shauna a few months ago when I attended what's called the M Chat here in Hobart and you were a keynote speaker and OMG like Not only was your knowledge like so amazing and like, as a scientist, my brain was just buzzing the entire time, but your storytelling, and I've actually spoken to so many people about this, because I'm enamored with people who can, you know, capture [00:10:00] an audience, because I have this real big thing with, um, academics or opinion leaders and stuff, and some people I can tell, I'm like, you are so knowledgeable, but you have no idea how to convey that knowledge. And oh my god, Shauna, you blew it out of the park. It was amazing.

Dr Shauna Watts: Thank you so much. That's really kind. I appreciate that very much. I do think that storytelling is something that's obviously been done forever and it's just such a great medium to help people understand.

Dr Renee White: Yeah, absolutely. And I think particularly in the area that we're going to be talking about today, which is perimenopause menopause.

It's still kind of this cutting edge research is coming through. Women's health hasn't been researched enough. I had a conversation with someone the other day and she was getting very upset about the fact that all this research has been done on men. Why have we not done enough research on women? And I tried to explain to her as, you know, an ex researcher, it's [00:11:00] expensive to research on women.

Sorry, but we are complicated human beings. That's just how we are. So obviously, first of all, for all those people out there who haven't heard about you, can you please just give a little brief introduction to the listeners about who you are and a little bit about your story. as you found yourself in this field?

Dr Shauna Watts: Okay, so obviously people probably listening are trying to work out what the accent is. So I currently live in Australia and I've lived here for 11 years and I moved to Australia with my husband who's also a doctor and our four children but I was born in Northern Ireland and grew up and spent most of my life living just outside Belfast and I did a little bit of a meandering journey went to medical school, 18 came out as a doctor at 23, but then had a little bit of a journey.

I had it in my head I wanted to be a surgeon. I wanted to be a [00:12:00] pediatric surgeon. And then I did some breast surgery and did various specialties. And then I had two children and realised that if I wanted to be a surgeon, I'd probably never see my children. So ultimately I decided. Um, for that and for other reasons, I suppose the main reason being, I realise I actually love talking to awake people and I really enjoyed explaining things to people and I always felt frustrated in the surgical space because I always wanted to know what happened next in someone's story.

I always wanted to know did that patient manage to get to her son's graduation or how did the wedding go? I always wanted to know all that stuff. So, I find myself swapping and becoming a general practitioner, which I've worked both in the UK system and the Australian system. And I suppose being a female GP, you do end up seeing a lot of women and a lot of children and I've always thrived on that.

I've enjoyed [00:13:00] mental health stuff. So, I think that's probably how I got to where I am a little bit. Um, career wise, and then I think over the last few years, what happened is I did segue a little bit more into doing some aesthetic medicine. So in and, but I really set that clinic up because I felt there was a group of women who were very ignored, which were basically that sort of 40 to 60 year old age group.

And I think it really began to resonate and those women were often talking to me, so while they'd be talking to me about their rosacea or their adult acne or their wrinkles or their, the fact that they were aging, they would also start talking to me about the fact that they couldn't sleep or that their weight was just going up but nothing had changed.

And so I was having these conversations in this one clinic and then over in my GP clinic, I was having people who were coming to see me about the same, uh, [00:14:00] physical problems or, menopause or period issues or whatever, but they would also ask me what should I do with my skin or what sunscreen should I wear?

Or how can I lose weight or whatever? And I began to think I'm having this conversation over here and this conversation over here, but the both are overlapping all the time. And I began to realise that I just couldn't actually separate the two. And so I wanted to have this quite holistic clinic where women could come and see me and we could talk about everything from perimenopausal weight gain to not sleeping to, you know, pain, having sex to weight gain to how they were losing confidence in their appearance.

And that I could actually look after all of that and I think I got to the point where it was after 25 years of being a doctor, I kind of gathered all this information and all this knowledge, and I was kind of like, I'm actually in a pretty good position to try and help these women. And then, as you know, because I have shared this story with you, I [00:15:00] had my own journey of really a very early menopause at the age of 33.

I had a surgical menopause with my fourth child, and it was, so I went from pregnant and within half an hour in the cesarean section, I had my ovaries removed and I was menopausal. And so I didn't actually have that perimenopausal journey. I just went from high to low and that had its own issues and to be honest, they're probably mostly things that I've, I've kept to myself for a very long time and I was navigating lots of health issues. But of course, like everyone, you kind of think, Oh, well, I'm really tired and I'm not sleeping, but you know, I do have four children or, you know, I've put on weight and I can't get this weight off and I've never been someone that my whole life with all my other three children.

I managed to always lose the baby weight, but the fourth one, I just didn't. But, you know, there's always a reason in your mind that you can explain everything [00:16:00] away. And, you know, I, like, like a lot of doctors, I'm really open in saying, I was a really bad menopause doctor for a long time, and I was a really bad menopause doctor for even myself, not that we should be our own doctors, but there were so many things that I didn't tie together at all.

And it's only really looking through that retrospective scope that I go, wow, gosh, you did yourself such a disservice because I really didn't actually go and seek a lot of help and I think I did occasionally bring things up to various specialists, but I kind of was just told, you know, Oh, well, you know, just try this or just try that.

And I always did leave feeling a little bit sort of smaller and a little bit embarrassed by having brought whatever that issue was up. And I think, you know, where I am today is that I just decided that I am going to try and use my voice and my personal [00:17:00] story in that with my medical knowledge to hope that people don't go through some of the things that I did go through.

And I think for me, if you're having a tricky perimenopause or postmenopause, it can be very lonely because it can often be symptoms that people don't necessarily feel really comfortable sharing. It can feel very private, very intimate, and also. If you're someone who maybe your group of friends are not at the same stage as you, then that's also really, really tricky because people don't understand what you're going through.

So I suppose this is where I am today, feeling very passionate about getting the information out there, but not only getting the information out to women who are in the thick of it, but also really taking the conversation back. Twenty years, not only for the women who are a significant number, who have a very early or early menopause, but also so that anyone like that women can go into it with the [00:18:00] knowledge that it's not such a terrible shock because so many women will come into me and I would say in 99 percent of appointments, women cry and it may well just be my face. That kind of face might make people cry, but I, um, I think that, you know, people are often at the end of their tether and they, they don't feel like themselves anymore. Yeah. And they'll say, I don't feel like me. I don't know who I am anymore.

The things that I used to, I used to be a very sociable person, but now I'm avoiding everything. I used to be someone who, you know, could do X. I used to be able to drive to the city and it didn't worry me. Now I'm terrified of being in the car. I used to be someone who was very confident at work, but now I'm shaking like a leaf and I can't remember what I'm meant to be saying next.

And so I think. you know, when you see that more and more you just think, I can only see so many people and I think, well, how many more people are out there who are, you know, at home just [00:19:00] feeling absolutely horrendous about the whole thing, you know?

Dr Renee White: Yeah, absolutely. I mean, the conversations that I've had since attending the workshop here in Hobart, you know, I've spoken to a variety of demographics, people in their 30s, 40s, 50s, 60s about this exact issue around you know, and it's funny because once I start talking about it people kind of creep out from the woodwork and they're like, oh really what was that and what did they say about this and oh yeah and I'll talk about the fact that essentially knowledge is power and when we have that knowledge we can make informed decisions and also the conversation around normalising this phenomenon that we go through because I've had discussions with people and they've been dismissed.

You know, you just have to suck it up. It's that stage of your life. There's nothing you can do. You need to, quote unquote, just push through. And you see these people, as you say, [00:20:00] they lose confidence. They kind of retreat, they don't want to be sociable anymore. And it's just horrible for them because someone along the way has just told them that they need to suck eggs, which is awful.

All right. I want to set the scene. I'm all about definitions because I love that as a scientist so can we just distinguish the difference between perimenopause and menopause.

Dr Shauna Watts: Okay. So this is probably going to shock some people, but the menopause is one day in your life, and that is one day exactly 12 months after your last menstrual period.

Now, like you, as a scientist, I love a good definition. Yeah. This is a terrible one because the reality is it doesn't really take into consideration people like me who had our ovaries removed. So not having periods or people who've had a hysterectomy who are not having periods. Like, so when's their menopause?

Because clearly they don't become menopausal [00:21:00] 12, exactly 12 months after their last menstrual period, cause if they've still got their ovaries, they're not menopausal necessarily. It also doesn't help people who have like polycystic ovaries or who have maybe a marina in and they don't have periods. So it's a tricky one.

It's the definition we've got, but that's base of it. So menopause is one day and in theory you are in the post menopause every day after that for the rest of your life. And that's sort of a hormonal state that you're in. The perimenopause is really a variable period of time when usually we see periods change.

So the periods become, become lighter, heavier. They can become more painful, less painful. They become, become cloddy, not cloddy. They become longer, shorter. And I would always say the only consistency is the inconsistency. So one woman might be saying to you, Oh my goodness, my periods in [00:22:00] the lead up to the menopause were horrific.

I was having to leave work, I was flooding my clothes. My iron was so low, I had to keep having iron infusions. And then you could have their best friend or their sister saying, Oh, well, mine was the opposite, mine got really short and really light and I literally only had to wear a little liner. I hardly even knew it was coming.

And so, and everything in between. And then also in that perimenopausal period, although the down, uh, the trajectory of hormone levels are from sort of, up here to down here, really, you know, it's not just you don't just do the slow and steady gradual reduction in hormone levels. I would say to patients it is a bit like a roller coaster.

So, you know, when you go to the fair and you to climb up all the steps to get to the top of the roller coaster. And eventually you do come out at the ground level and, you know, you walk off feeling like, ah, well, perimenopause is a bit like that in that, yes, you end up down at the bottom eventually, [00:23:00] but you do a lot of loop the loops and climbing and up and down and up and down.

And I think that's the best way to describe it. It is literally a roller coaster and it's probably that roller coaster that makes it such a challenge because you could take someone's blood on Monday morning, and their levels are here, but you could probably take their blood on Wednesday afternoon, and it could be up here.

And that is why taking blood tests in the perimenopause is not the way to diagnose it. It's really a clinical diagnosis. So the perimenopause, we know, probably lasts anything from 2 to 10 years. So if we think about we're obviously Australian based, so if the average woman is 51 to have a menopause, that still means that having a menopause at 45 is normal and having a menopause at 56 is normal, so that's still considered completely Mrs. Average. So let's say you're 45 when you have the [00:24:00] menopause day, then in theory, you could be having symptoms from your 35. And therefore, that's why I feel like we need to bring that conversation back because we have, and I know over the years, I've seen people as a GP who come in complaining of vague symptoms like fatigue and headaches and, um, you know, just not feeling themselves and feeling a bit irritable and, you know, we would have run. Oh, well, everything looks fine. It just must be that your life's too stressful. And of course it may well be that their life is very stressful, but it may also be that actually they were already in the beginning of the perimenopause.

So I think those are how I understand the definitions. Pre menopause, you're pre menopausal basically from puberty until, um, you get to the menopause. So there's pre, peri, post and menopause. Um, but you know, they all get interchanged. And so we'll, people will often talk about being menopausal or being [00:25:00] perimenopausal or being postmenopausal, but I always think probably don't get too bogged on by the names.

most of the time, you know, we get the gist of what you're meaning.

Dr Renee White: Thank you for clarifying that. And yes, it's not as black and white as what we, I think, assume in the mainstream media and things like that. One of the things that really enlightened me at the workshop was that we hear a lot about oestrogen and oestrogen, oestrogen, oestrogen, because there's oestrogen gels, but something that you touched on was it's not just oestrogen that we need to be monitoring.

There's two other hormones, progesterone and testosterone as well. Can you just kind of expand on that? Cause I found that fascinating.

Dr Shauna Watts: Yeah, absolutely. So let's talk about progesterone first of all. So it used to be that we gave you progesterone because if I gave you estradiol or [00:26:00] oestrogen and I didn't give you progesterone, the risk is that the lining of your uterus will get really, really thick, and one, you'll end up with horrible bleeding.

But the second issue is that there is a small risk of, um, making you have more chance of having endometrial cancer, so that's a cancer of the lining of the uterus. Now you can have developed endometrial cancer anyway, but we know that if you have what's called unopposed oestrogen, i. e. you don't have progesterone kind of counteracting it, then that does increase your risk.

And that used to be the only reason that we gave progesterone, and if someone had had a hysterectomy, et cetera, we just didn't give them progesterone at all. And that's still the case. You definitely don't need to have progesterone. I think what's going to be really interesting with time is that I think we're realising that these hormones do a lot more than we had originally thought they did.

And it would seem that progesterone has other roles and is helpful [00:27:00] for other things. So for example, I find that progesterone, when I'm giving that to patients, I like to give it in the evening because it does seem to have a bit of a sedative effect. And as we know, lots of women in the perimenopause are struggling to sleep and if you give them some progesterone, it seems to help that a lot.

Now don't get me wrong, oestrogen and estradiol also seem to help sleep. But I think in medical terms, we've probably oversimplified these hormones a lot, you know, it's always been, oh yes, oestrogen, it's all about the hot flushes.

Dr Renee White: Yeah.

Dr Shauna Watts: And progesterone, oh, you just need that for uterine protection. But I think the reality is that more and more, we're realising that these hormones have receptors and all sorts of organs in our body on muscle on bone.

And clearly, you know, bodies are clever things. You're not going to have a receptor on a saddle if that thing doesn't go there and do something. So I think, [00:28:00] you know, watch this space. I think. 10 to 15 years from now, we're going to look back and think we had an overly simplistic view of progesterone. And some women do choose to have progesterone, even if they've had a hysterectomy.

And, and that's just something to discuss with your doctor. The other one that people seem to be really surprised about is testosterone and lots of people. Unfortunately, think of testosterone as being a male hormone and for years, unfortunately, all of these hormones have been called sex hormones. And so in our mind, we've thought of all these hormones, Oh, when you get to puberty, you know, Oh, females, they get a real spike in oestrogen and they grow breasts and all the things.

And then guys, well, they are their penis enlarges and they get, you know, hair growth. But the reality is that both of these hormones are active in both, both genders, basically. So, you know, if you took, uh, let's say a theoretical 55 year old couple, um, with a, [00:29:00] uh, a male and female partner, and the female is postmenopausal, well, and she's not on hormones.

Well, her partner has more estrogen in his body than she does. Okay. Men have estrogen. And conversely, if you look at a young, let's say 27 year old female, when she's at that age, she has probably about four times as much active testosterone in her body than she does oestrogen. So testosterone is a very important hormone for both sexes.

And what we know as well is that testosterone, like I think we all know, like people will sort of know sort of like, Oh yeah. Such and such. He's a bit aggressive or he's a very angry guy. Right. And he's got a bit too much testosterone. Testosterone, yeah. Yeah. Yeah. So we kind of all know that testosterone clearly has impacts in the brain.

Yeah. 'cause clearly anger and, you know, irritability and things like that come in the brain. And yet it seems to be a surprise to [00:30:00] people that actually all these hormones are very active in the brain. And our brain wants them and it needs them. And we know that all of those hormones are very, very helpful.

So sometimes women are very taken aback to know that actually testosterone is really important for them. We know that testosterone actually begins to reduce well before the perimenopause actually. It's dropping off really from the thirties. But for example, if you have a woman who has her ovaries removed.

And everyone often thinks about, Oh, gosh, do we need to give you replace your oestrogen? But often people forget is that they've just taken away 50 percent of that woman's testosterone. We know, unfortunately, again, most of the research is done in men, but if you look at men who've got very, very low testosterone, they will barely be able to get out of bed.

They will have horrendous muscle fatigue. They often develop abdominal obesity. They [00:31:00] look very sort of skinny in the arms. They lose a lot of their muscle mass and they'll often be quite depressed and lethargic. And obviously, can't always extrapolate between the sexes, but it would suggest that this dropping of testosterone probably does explain some of the symptoms that women are suffering from.

Now, in Australia, we're really lucky because we've got a female dosing uh, cream that basically is testosterone and it's in the female dose because there's no doubt the dose that women need is significantly lower than what you would need for a man. So we're really lucky we're actually the only country in the world comes a little white and pink tube and apparently it's imported Um privately by people all over the world, but we're the only country that has it but it has a license only for libido And so what that means is that, strictly speaking, you're only meant to be prescribed that by licensing, [00:32:00] um, if you've got a low libido and you're not meant to be prescribed it for anything else.

The jury is on it. I always say to people, look, the reality is, again, we know that libido is very much a brain symptom. Do we really think that the only thing testosterone does in our brain is to give us sexual libido.

Dr Renee White: It's so, it, it's, it just screams like male masculinity, like, oh, it's the only thing that this can do. It has to be done with, like, it has to be with sex. It's like, what are you joking me?

Dr Shauna Watts: It's very frustrating. So I definitely have patients who will tell me that, yes, it, it, it does improve their libido for sex, but actually they, I think Louise Newsom describes it as libido for life. So zest for life. People will say they've got their zest for life.

They're more enthusiastic about doing things. Some patients will say they feel like their mental [00:33:00] clarity is better. And some people will say that they feel like when they go to the gym, that they, have a lot more strength than they had before. Look, the jury is out. We've still, we still await lots of research.

And I think that's probably one of my frustrations is that I just was at the International Menopause Society, uh, conference and it was fabulous, but it was definitely lots of, Oh, but we need to wait to have X, Y, and Z randomised control trials and anyone in the scientific community knows one, they're really hard to do, two they're really expensive to do and three, they take a very, very long time. And so, really, are we so we can only do these things once we have all these randomised control trials. And this is just my personal opinion, but it seems like the bar is set very, very high for anything to do with women and hormones.

We seem to have to have [00:34:00] absolutely exemplary evidence before we're allowed to do things when in actual fact, for other medications or other treatments, we seem to set the bar a lot lower and we seem to be a bit more accepting of this. Quite good. Uh, medications and treatments will often get through the TGA and the FDA based on one study, not necessarily a big randomised control trials.

So I do feel a little frustrated that sometimes we're so busy chasing these studies that you know, no one seems to be doing, which means we're never going to get the result, which means we're never going to be allowed to do the thing. And yet when you talk to doctors like me and you know, I'm in a group of lots of doctors who work in this space and you know, we know what we see and we know that.

And, and don't get me wrong, I, I feel like testosterone is what I would call more of a slow burn hormone in that when I give someone EstroGel or estradiol, pretty quickly, I [00:35:00] honestly would say within two to four weeks they will come back and they'll be like, yep, I already am beginning to feel better. I do feel that testosterone is a lot more, uh, a lot more patience is required. It seems to be a bit more of a slow burn. I'm not entirely sure why, but one tube of testosterone at the initial dose will last you 100 days. So that's over three months. And I usually say to patients, you're going to have to give it that full tube at least before we make a call as to whether it's going to be helpful for you or not.

It's not something that you're going to know is going to work in, you know, 10 days. But yeah, so I think people are always surprised a bit that testosterone is relevant in this space and I think you know lots of doctors are really scared of it Yeah And I think lots of patients can be really scared of it But other patients have really educated themselves and will often come up specifically asking for it but I do think I would like to say is that [00:36:00] it does need to be prescribed by someone who does have experience and who also is going to monitor you because I think that's really important.

So it's one of the hormones that, you know, we do want to check and see what levels are. And that's something that I check on a long term basis as well. So, you know, at least every six months I'm checking it and making sure I know what the level is because we don't want you to go too high.

Dr Renee White: Yeah, it's definitely not one of those things where you go set and forget, you know, like you want to be checking back in and making sure and as you say, you know, that's, that's the opportunity where you come back and go, okay, well, let's read the blood test because now we're actually got some things into play. Um, you mentioned the, um, conference, the, is it the World Symposium?

Dr Shauna Watts: Yeah, sorry, yeah, so it was the World Symposium.

Dr Renee White: Yeah, yeah. You touched on a bit of research. Again, this is an area that I am slightly obsessed with. Like, just on the periphery, gut [00:37:00] microbiome. What is going on in that space? Because you know, we, we know, and I've spoken about it on the podcast before, we know that this is a very kind of evolving sector when it comes to lots of different disorders, diseases, and things like that.

It's, it's a work in progress, but in terms of perimenopause and menopause, what is it that we know about the gut microbiome?

Dr Shauna Watts: Well, certainly it would seem based on some of the, there's a lot of really good research actually coming out of the UK. I really enjoy. There's a really good podcast called Zoey and they're very helpful and they present a lot of nutritional, uh, information.

Mm-hmm . And they, um, have presented some quite interesting data that you are seeing a shift in the gut microbiome in the perimenopause and postmenopausal woman. So if you compare. And look, obviously everyone's gut microbiome is very individual, but if you kind of [00:38:00] look at trends, it would seem that the gut microbiome does transition to be a less healthy gut microbiome.

And what they are trying to really understand and pinpoint is, is that one of the causes of the weight gain that people see? Because the reality is that, that is a big issue for so many women. I mean, I would have to say, although everyone always thinks of menopause and hot flashes, hot flashes are not the main complaint that I see.

I see lots of different, but I would say sleep and weight gain are two in the top three, definitely of things that people are upset about. Not only weight gain, but real change in body shape. So people really complaining about getting this abdominal obesity that they've never had before. And there's no doubt that some people will put on weight.

Some people will put on significant weight, [00:39:00] but even women who really don't put on much weight will say that their clothes fit differently. Everything's tighter around the tummy. And that's because we know there's this shift in where we're putting fat and our fat stores really change, so when we're younger, we tend to put fat under the skin.

It's called subcutaneous fat and we all have it, you know, on our faces and you have it really all over your body. But what sort of shifts it would seem is that we now start to lay down this stuff called visceral fat, which wraps its way around your organs. And we know that it is quite different. It doesn't behave the same way as the fat under the skin.

So a lot of these researchers are trying to understand is, you know, is the gut microbiome in some way connected to this? And, and to be honest, at this stage, we don't know, but it would seem that the gut microbiome seems to be shifting in a way that seems to be more obesogenic. And one of the pieces of research [00:40:00] that I found really interesting was, I can't remember it was mice or rats, I think it was a mice study or mice study that they did.

And they took some of the gut microbiome, um, of, of patients and the mice were a normal weight and they didn't change their, their access to food, but just by putting some of the gut microbiome of people who were obese into these mice within six weeks, then the mice were obese. Yeah. Nothing could change in their food and I find that so interesting and it's obviously can't say that we're exactly the same as mice.

Clearly we're not, but that's how research tends to start, but I think it makes us really begin to question some of the things that we've always thought about. Um, weight gain and, you know, perhaps we have lived in a bit of a blame culture, um, whenever in reality, you know, it's clearly much more complex. So sorry, that's a very long winded way of saying, I know there's,

Dr Renee White: it's [00:41:00] fascinating.

Dr Shauna Watts: We know there's a shift in the microbiome at this stage. You know, the jury is out. There's definitely lots. of groups around the world really actively researching this to try and understand why that is. And I think what I take away from it at this point from my patients is, and anyone listening is, it really is now this time of your life, particularly if you've never done it before, this is the time to say, okay.

Unfortunately, at this point, my body is kind of working a little bit against me. So I am actually going to have to really try and ditch the ultra processed food. I'm really going to have to eat the rainbow. I'm going to have to bump my fiber up like never before. I'm going to have to not have broccoli as my vegetable every night.

I'm going to have to have more variety because we know that doing those things is much more helpful. I'm going to shift that microbiome. It would seem back more in the better direction.

Dr Renee White: Yeah.

Dr Shauna Watts: So it's definitely very early in, uh, research, but I think it's [00:42:00] so, so interesting.

Dr Renee White: Yeah. Yeah, definitely. Just as a side note, my husband, he has gut issues and I, um, for Christmas a couple of years ago, I got him one of those, um, microbiome tests that like, you know, you poop in the thing and send it off.

Oh my God. Like 70 page report comes back. It was like heaven for me as a scientist. Um, so that's how obsessed I am about it. Shauna, we are going to go through a little bit of a rapid fire because I, um, sent a little message out to our listeners and audience on, um, Instagram. So if you were happy to indulge me in some of these questions, um, That would be great, because these, I think these are like some burning questions that lots of people have.

Um, okay, first question is, and you've actually, you've already answered this one, why do doctors insist on sending you to do a [00:43:00] blood test even though levels fluctuate? Why, why, are people not up with the, with the go on that? Like,

Dr Shauna Watts: I think there's two things. To be honest, when I see patients, I do send them for blood tests, but I'm sending them for blood tests because I want to know, are they iron deficient?

Because they've got rotten periods or, you know, we can see vitamin D deficiency. We see cholesterol bouncing up. We often see, unfortunately, women self medicating with alcohol. So, I want to check their liver function because lots of women can't sleep or they're feeling really anxious, so they're drinking more.

And so, I'm wanting to make sure that I'm not attributing things that actually are related to something else. I want to know, is their thyroid okay? I want to know if they are insulin resistant. Are they pre diabetic? So, I think it is a good thing to have blood tests. To be honest, I do check hormone levels.

I check a testosterone level as well to see where we are with that. But you're [00:44:00] absolutely right. No doctor should be saying to someone, uh, your hormones are normal, so it's not the perimenopause. Because, that is not how you make the diagnosis of the perimenopause. Your hormone levels will be normal, whatever that means.

They'll still be within what's considered a non postmenopausal range. And I still think that it is good medicine to make sure that someone isn't sitting with, you know, because perhaps their palpitations are coming from an overactive thyroid and not because they're perimenopausal. So I think it is good medicine to have a blood test, but yes, your, your, um, listener is completely right.

It does seem a bit crazy that we're doing it, but it is the right thing to do.

Dr Renee White: Yeah. Okay. So you want a clean slate before you like, you know, you've got to have all the facts in front of you and then to make the diagnosis.

Dr Shauna Watts: Yeah, because we don't want to flip the other way where for years we've ignored the perimenopause and brushed it all away.

But now we don't want to say that everything's the perimenopause. And [00:45:00] actually. we're missing someone that actually has another significant health condition and then we're completely barking up the wrong tree. So that would be my reasoning.

Dr Renee White: Okay, great. Thank you for that. Um, another question. Can you take your MHT separately, i. e. gel in the morning and your Prometrium at night?

Dr Shauna Watts: Absolutely. 100%. You do it whenever it suits you. So if I always say to my patients about their gel, do it whenever you've got the time and patience to let it dry and I encourage my patients to have their Prometrium in the evening, because as I said, for some people, it can have a little bit of a sedative effect and help them sleep. So I'm really happy. I personally do split mine as well. So yeah, absolutely fine to do so.

Dr Renee White: Okay, and on that aspect of, um, the gel, um, there was a follow up question. How do you apply EstroGel? Massage deeply or lightly into [00:46:00] the back of the arms? Does it make a difference?

Dr Shauna Watts: So, um, the way I encourage my patients to do it, and you will forgive me, but I actually don't use my hand to do my gel, so I actually pump my gel onto my wrist, and then I rub it with both arms like this, and I spread it all over.

And the reason that I do that is, as a doctor, I'm just washing my hands every 15 or 20 minutes between patients. And I kind of feel like there's no way this is all absorbed in 15 minutes. Like it takes a while to absorb in and I don't want to lose my dose. So I, I know it looks a bit weird, but I actually use my other arm to do it.

But yes, I personally like patients to really spread it well and thinly. We know it's absorbed better. I have seen some people really leaving it as quite a thick glob on their arm and that's going to take a really long time to be absorbed and also high risk of you rubbing it off on clothing or something else or someone else. I personally [00:47:00] think. thin and widespread and then it's going to be absorbed over a bigger area as quick as possible.

Dr Renee White: Okay, um, next question and I think I asked this to all of you at the M Chat, um, what is better, um, the question is what is better body identical estradiol gel or patch. So what is the difference between the gel and patch?

Are they the same or not?

Dr Shauna Watts: So, so basically you can get estradiol in a patch and in a gel. Obviously there are some other synthetic older ones that we don't use as much. Um, look, they're, they're very similar. Um, in ways a patch is easier because of course you, you slap it on and then you forget about it for three and a half days until you have to change it again. We've got a couple of issues in Australia. One, there's a worldwide shortage. We're very far away. We're a very small market and therefore, you know, we just seem to get them in really dribs and drabs. And I find it really frustrating for patients.

And also I have to say as the doctor, [00:48:00] when you're getting endless phone calls saying, I can't get this, can you leave me out another prescription? Like it's very time consuming. And so, um, the reality is that I have to say I steer towards get at the minute because we have, gel is actually here on, on site manufactured here.

So we know we've got a big supply because it's an Australian company that make EstroGel. So, but I think they're both as good as each other. I think the advantages of a patch is you don't have to remember every day. The disadvantages, are you going to remember every three and a half days to change it?

Dr Renee White: Yeah.

Dr Shauna Watts: And the other thing I did personally find with patches, uh, were that because of the heat here and the fact that people tend to live quite active lifestyle. So people are often swimming in the sea, surfing, hopping in and out of swimming pools, showering maybe two, three times per day. You can get um, a little bit of sort of rash under the patch because [00:49:00] it can be a little bit irritating to the skin because you've got like a bit of sweat and heat and moisture building up.

So I would say that for some women that can be a challenge, but they're both really good options. It's really just that availability. That's the issue right now.

Dr Renee White: How big are the patches?

Dr Shauna Watts: So they really, so there's ones that are really quite small.

Dr Renee White: So like 20 cent piece or?

Dr Shauna Watts: Dot, yeah. And they tend to have the word dot on them. And then there's other ones that are much bigger. At the minute it's very hard to get the dot patches. Gotcha. But it is a worldwide issue and I think, look, the reality I think is that we've had this complete awakening of people in the last maybe three years where people are like suddenly really interested, motivated and I don't know, I think the collision has been in my mind.

That, you know, as much as we love to hate social media, social media, podcasts, [00:50:00] and um, also a generation of female doctors coming through the ranks who've had their own symptoms and who started to go, ah, and start talking about it. Enough is enough already, right? And I think to be honest, the industry who make patches and all sorts of hormone replacement therapy.

I don't know that they saw it coming and they just haven't really have the infrastructure to meet the demand at this stage.

Dr Renee White: Yeah, I want to add another demographic to that group and it is, I'm squarely in the middle of it. It is the daughter of a mother who is currently going through it, who is bitching and moaning at you. I love you, mummy, if you're listening. Um, she comes to me and she's like, what is this? Like she, I said to you at the M chat, I was like, my mum is like up in arms because there's a shortage of patches and I don't know what to do about it. And what is going on here. And then when you would like get the gel, I'm not joking. I went, sat back in my seat and I [00:51:00] typed out to mum and I was like, get the gel mum, just get the gel. And she was like, okay, I'm onto it now.

Dr Shauna Watts: I think there's another group of women as well, though. I, I do feel sad for as well. And that's the group of women who over the last 20 years, you know, really were denied hormone therapy.

You know, there are a group of women who are maybe nigh in their. Early seventies, uh, or late sixties, you know, they, they kind of missed out and, and they were probably a generation where there, there was not the same amount of information. They would have been shut down by a lot of doctors, including myself.

I'm not gonna, I'm not sitting here saying I've been perfect about this. We were literally told 21, 22 years ago when I worked in the UK. All the patients have to come off hormone replacement therapy anyone that you see who comes in, no more repeat prescriptions get, you know, everyone was brought in and stopped over.

And I can't remember exactly because it was 20 plus [00:52:00] years ago, but we were pretty much told that you wouldn't be insured like your insurance, would be indemnified if you know, patients were left on it. And obviously I was a young doctor. You kind of do what you're told. And, you know, it was just really something that I didn't really offer to people for a very long time.

So I do feel sorry for those women because I think it was a generation where things often weren't talked about as much as they are today. And I just think of all those women who have suffered. It's awful to think.

Dr Renee White: Yeah, absolutely. Oh my goodness. Um, another question, when do you start to worry about brain fog?

Dr Shauna Watts: Okay, so

Dr Renee White: Is there, is there like a line in the sand?

Dr Shauna Watts: There's a line in the sand. I'm, I'm presuming what your listener is referring to is when is brain fog, not just brain fog, and when is [00:53:00] it something more sinister?

Dr Renee White: When is it, when is it, oh, I'm, like, you know, we've touched on it many times, like, you've probably got a stressful job, and you've got kids, and you've got a house, and blah, blah, blah, and all those things, and then there's the forgetfulness. Yeah, when does it become a point where you're like, actually this is something I probably need to look into?

Dr Shauna Watts: Yeah, look, I think the reality is there's no doubt there's many women come in and they're absolutely convinced they've got early onset dementia or I even have patients who are convinced they must have a brain tumor.

Dr Renee White: I spoke to someone yesterday about that, she was convinced.

Dr Shauna Watts: Yeah, I've even had patients convince me that they've got a brain tumor, to be honest. So we've gone off and had an MRI scan and things. Um, and look, sometimes that's what needs to be done. But I think the reality is that, you know, it's coming and having a conversation, hopefully with a health professional who can say to you, actually that, that is finding a little bit concerning.

I mean, I think if, if someone is [00:54:00] coming out to their car. I mean, I'm not going to lie. I've forgotten which car park I've parked in at the shop center or what level I'm at and I find myself walking up and down frantically trying to think what was I doing when I drove into the car park and which level so I think, but I think if that is something that is happening and you physically didn't remember that. In fact, you took the bus to the shopping center and and or, you know, you're just constantly doing things that are really outside the parameters and that maybe work colleagues and things are saying to you, like, that we're really concerned about you, then I think it's definitely worth having the conversation, but I think in reality, it's still very, very likely to be the fact that, you know, you've got menopausal symptoms and, you know, you may well be sleeping horribly, completely exhausted.

And I don't know if you've seen recently, they, they, they did show some pet scans of [00:55:00] people's brains when they were actually having a hot flush and what is actually happening within the brain.

Dr Renee White: I haven't seen those ones

Dr Shauna Watts: Yeah, it's completely amazing and it literally is something very active happening in the brain. And so you kind of have to think to yourself, well, no wonder your brain's not working properly if all that's going on. So I think the bottom line for me would be that the vast majority of people don't actually have to worry about a sinister diagnosis, the brain fog is definitely real and it's incredibly common.

People don't feel as sharp as they did. But I think all that being said, I always like to say, but that doesn't mean I'm dismissing you. Go and talk to someone if you're really worried, or if you have a significant family history of people in your family with neurological conditions or early onset dementia and things like that, of course you need to go and have the conversation.

Dr Renee White: Yeah, absolutely. I'm going to be really indulgent and I, cause [00:56:00] I actually had this in my chat with my closest girlfriends and, oh yes, there's these patches that my friend, friend sent me and they look like they've got like all these natural ingredients. Uh, what is it? They've got things like, uh, I didn't even know how to pronounce some of this.

Uh, Gotu Kola, Damiana, Black Cohosh, Valerian, Skullcap, Oatseed, Ginger, my friend sent it to me and she said, because I'm the science nerd in the group, have you heard of this? Do you know what this is? And it's kind of tag, it's, uh, it's a, it's a menopause patch. It's being like kind of pitched as, and my response was. Oh, well, I'm chatting with Shauna next week. I'll ask her. Have you heard about these?

Dr Shauna Watts: I actually had a patient mention it to me a few days ago. I didn't look into it any further, but you know what I would want to say is, [00:57:00] what can be more natural than actually giving your body back a hormone that it already uses and knows how to metabolise and it's got receptors for, as far as I'm aware, our bodies don't have receptors for black cohosh or any of those other things.

So that's it. Yeah. So black cohosh and red clover are some of the naturopathic things that they would use for menopausal symptoms. Some people find it helpful, but it hasn't, they haven't really stood up. They actually are. I've had multiple clinical studies which have shown that they don't seem to do much.

So in my mind, why would you buy a probably not inexpensive patch to, and think it's more natural than actually just giving your body back its own hormones? Wouldn't that be the most natural thing to do?

Dr Renee White: Yeah, because I actually, I think this is a really good point to clarify that, you know, when we're talking [00:58:00] about patches and gels and things like that, the chemical formulation of the hormones of oestrogen in them are exact replicates of what the biological or the physiological versions are in our bodies.

So they don't have all these other little bits and pieces hanging off them that, you know, we do see in kind of other spheres of the pharmaceutical market. It is like one to one copy and paste.

Dr Shauna Watts: They're absolutely identical. And, you know, isn't it interesting again, is that people don't seem to be super worried about, for example, a lot of the contraceptive pills and don't get me wrong, I think contraceptive pills being great and liberating and all the things that it's done for women is wonderful. But the reality is that those are synthetic. A lot of them are synthetic. More recently in the last couple of years, there's a few that have come on the market that are much more identical, but most of them are synthetic.

And yet, actually, no one seems to really lose too [00:59:00] much sleep about taking those. And so, I think there is just this one inherent fear of hormones, which is completely understandable both among, uh, lay people and the medical community, which really needs to be not completely, you know, we need to press the reset button and look at this again, because that fear is really unfounded and we seem to be largely unafraid of other pharmaceuticals, but yet we, there seems to be this fear on these and then I think, you know, the other aspect is that, you know, why are we so afraid of this, but yet we're very happy to take other synthetic versions earlier in life.

Dr Renee White: Yeah.

Dr Shauna Watts: And I think that it's, it also, I think feeds into a narrative, which you started to talk about right at the beginning, which is that suck it up, just accept it. You know, menopause is natural. So why are we [01:00:00] trying to fight it? That kind of thing. But, you know, I think. The reality is that we have, I've lived evolution in a way, you know, what's probably not natural is us living to 85 and what's not natural is most of the food that we eat most days.

And, you know, if you want to be natural, then you're going to have to, you know, not dye your hair anymore and not wear shoes and not drive a car. Do you know what I mean? Yes, I feel like we have to like really be very careful about what we say is natural and what isn't natural. And you know, childbirth is natural, but we still help people and we give them pain relief.

And to be honest, cancers are natural and thyroid problems are natural, whatever natural means, you know, they happen. And we do help people with all of these, but yet it seems like there's this. block about actually, um, helping women in this situation whenever they're, um, symptomatic. And it seems [01:01:00] like there's this messaging, which is it's only if your symptoms are horrific, you know, you can suffer quite a bit. But if you're suffering horrifically, then you're going to have hormones. But if you can just manage with that small amount of suffering, then that's okay.

Dr Renee White: That's okay, everyone. Yeah.

Dr Shauna Watts: And it's kind of a bit weird, isn't it?

Dr Renee White: It is so weird!

Dr Shauna Watts: We say to other people, oh, well, you know, we know that you've got that awful earache, but why don't you just try and suffer on with it for a little while longer? And if it gets absolutely skull splitting, then we'll give you some pain relief.

Dr Renee White: Yeah, you've got to meet, you've got to meet all the thresholds before we're willing to kind of, you know, give you a bit of grace.

Dr Shauna Watts: Yeah, so bizarre. And yet, and what I will say as a doctor is that hormones are probably one of the most satisfying things to prescribe because I have to say, They work really well. Like people come back and they're like, wow, feel dramatically better. Whereas if you put the [01:02:00] same person maybe on an antidepressant or whatever, yeah, don't get the same impact.

Dr Renee White: Nah, hit and miss. I'm mindful of our time, but I, and I think I'm, I'm actually going to be able to integrate one of the, um, listeners questions into our own rapid fire that we always ask our guests. So if you're happy to indulge me on that, um, that would be great. But our first question that we always ask, what is your top tip? Uh, I have it for like, um, pregnant people, but I'm, I always put it into context of like, what's your top tip, I guess, for women who might be experiencing perimenopause or menopause at this minute?

Dr Shauna Watts: I think my top tip is actually to prioritize sorting out your sleep. Because I actually think that sorting our sleep actually helps so many other symptoms. So we all know that if we haven't had enough sleep we're going to be really grumpy and irritable with everyone, but we also know that if we're not having enough sleep that we're not going to feel like connecting with people, we're [01:03:00] not going to probably make good food choices.

We're going to have high cortisol levels, so it's going to be really hard to lose weight. We're not going to be motivated to go for that walk or go to the gym. We're not going to be motivated to socialise and connect So for me, actually, my top tip would be prioritise sleep and do the things that you can do as well. It's not all going to be just that the hormones perhaps are going to be the miracle.

If you've got a bedroom that, you know, you're crawling over three baskets of laundry and ten piles of paperwork, and your, you know, your sheets are really uncomfortable, and your bedroom's way too hot, and, you know, your curtains let the sun in. And, and, and, and, and, you know, then you're probably not going to have a really good night's sleep.

So it's like trying to make that your sleep and sleeping environment is really, really, um, going to be a positive one that you want to go, you want to lie on your bed. It's comfortable, the room's nice and cool, and it's conducive to actually sleeping well and I personally think that getting sleep sorted is [01:04:00] such a priority for my patients and I feel like when people sleep, the whole world feels sunnier.

Dr Renee White: Absolutely. Um, great tip, great tip. I'm a huge advocate for prioritising sleep. Um, so one of the, uh, audience questions was around resources on this topic. What are your favorite kind of books and resources for this one?

Dr Shauna Watts: So there are lots of great books out there. I, the books that I love are I've read recently, again, are Estrogen Matters by Avron Blooming. I think that's a great book both for patients, doctors, nurses, anyone in the medical arena, but also a really interesting one for anyone with a genetic propensity to breast cancer or who's had breast cancer.

I also love, um, You Are Not Broken by Kelly, Dr. Kelly Casperson, um, who is an [01:05:00] incredible female urologist from the U. S. She's fabulous I've had her on my podcast. She's fun and she just breaks down all the taboos around. sex and all the urinary symptoms and things. And I think, you know, the reality is we haven't had much time to touch on it, but lots of women are left feeling like they are broken.

A lot of women, not only do they not have any libido, but actually having sex for a lot of women is it's not just about it being a little bit dry. It's downright painful, really uncomfortable, almost impossible and I think a lot of women feel like they just have to potentially end their relationship because They feel like in some way it's not fair to their partner.

So I love her book. And then I also, I'm a big fan of Dr. Louise Newsome from the UK and she's got a book called the definitive guide to the peri and post menopause. I think it's called her peri and menopause. It's a very good book as well. I also think that um, [01:06:00] Louise has an app that is really helpful.

It's called the balance app and it's free and it's a really, really good app with lots of information on there and I know that Dr. Louise has invested so much time and energy into that one, and also my podcast, lots of lots and lots of interviews with some really fantastic doctors, psychologists, neuroscientists, all sorts of people on there, dieticians, nutritionists, even dermatologists, dermal clinicians, because of course the reality is that this is something that impacts everything, skin face, body, everything.

Dr Renee White: Mm, I love that. I'm gonna be like, just sending this um, whole episode to my mum in its raw format, not even edited. I think she's waiting, she's like, I just need to, all the, all the information. Now, last question that we ask all of our guests, and we borrowed this one from Brene Brown, is what do you [01:07:00] keep on your bedside table?

Dr Shauna Watts: I love Brene Brown.

Dr Renee White: I know, isn't she fab?

Dr Shauna Watts: Oh, I love her. She's, she's like my, she's on my bucket list of who I can get on my podcast. She's one of my dream guests. Uh, what's on my bedside table? Well, right now, a couple of those books that I've just mentioned are on my bedside table. Um, usually a glass of water, which may be a couple of days old.

I actually also do have my EstroGel and my testosterone on the side of my bed because I'm very busy and occasionally I realise that I've forgotten and so I have them at the side of my bed just in case I haven't, um, put them on. But yeah, that's all that's there. Nothing too exciting.

Dr Renee White: No, that's, that's great. Um, thank you so much for joining me today. I really appreciate it. Um, It was, as I said, amazing to see you speak, um, in Hobart the other month [01:08:00] and I know for a fact that so many people, my mum included, are gonna love this episode, um, because it's just, I think, normalising the conversations and making people aware of their options and the fact that they're not broken and they're not going mad and there's something that they can do about it as well, which is so, so empowering.

So thank you so much. For coming on for all the listeners. How can we kind of get in contact with you? Where are your socials? Where is your clinic? All of those things. Oh, and your retreat. That's coming up too.

Dr Shauna Watts: Yes. Okay. So I'll tell you quickly about our retreat. So. From the 30th of May to the 1st of June, we're having a retreat. So I'm based on the Central Coast, anyone who doesn't know what that is, it's about 90 minutes north of Sydney. It's a very kind of beautiful beachy area. So I'm having a full weekend retreat. So there's going to be all sorts of specialists from all over Australia. We're going to have a [01:09:00] sexologist and relationship therapist, hormone experts, we're having skin experts, we're having, you know, bladder experts, we're having an amazing psychologist, and we're gonna have all these workshops, um, intermixed with some fun activities, um, we're gonna have sauna's, ice baths, um, for anyone who's brave enough.

Jacuzzi pool, beautiful food, fun times, um, just women creating a bit of a community and having that confidence to be able to ask some real experts in the space the questions that they've been dying to ask and even if they don't feel confident enough to ask them out loud, we're going to have a little box and we'll have all your questions.

So there's going to be some incredible learning that weekend. So I'd love, some of your listeners to join us and my social, so you will find my podcast is called All About You with Dr. Shauna Watts. Um, and you'll find that on Apple, [01:10:00] uh, Spotify and also on YouTube. Um, you'll also find my Instagram of the same name.

And then my clinic is called you, Y O U. by Dr. Shauna Watts and that's also got a lot of information on there and you'll find that on Instagram, Facebook, um, LinkedIn, all, all the places. So all the usual places, but I'd love to hear from your listeners. I'd love them to reach out to me and, you know, even if they have some ideas of things that they would like me to talk about or present on, then I'd love to have that feedback.

Dr Renee White: Amazing. Thank you so much. We're going to put all of that in the show notes so people have instant access to all of that. Thank you again, um, for your time.

Dr Shauna Watts: Thank you for having me.

Dr Renee White: And, um, yes, to everyone listening, thank you so much. And please feel free to reach out to Shauna. Until next week, we will see you.

Dr Shauna Watts: Bye.

Dr Renee White: If you loved this episode, please hit the subscribe button and leave a review. If you know [01:11:00] someone out there who would also love to listen to this episode, please hit the share button so that they can benefit from it as well. You've just listened to another episode of the science of motherhood proudly presented by Fill Your Cup, Australia's first doula village, head to our website.

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