0:00

This episode is proudly sponsored

0:02

by Lulu Lemon. We

0:05

would like to begin by acknowledging the

0:07

traditional owners of the land in which

0:09

we record this podcast today, the Arakwa

0:11

people of the Bundjalung Nation, and pay

0:13

our respects to elders past and present.

0:17

Hello, yummy mummies.

0:24

Welcome to Beyond the Bump, a podcast

0:26

brought to you by Jane Caldwell and

0:28

Sophie Pierce. This podcast

0:30

is targeted at mums, mums to be,

0:32

and women in general. And

0:34

gents, feel free to have a listen too. It's

0:37

a place to have real discussions and

0:39

ask real questions, no matter how hard,

0:41

with honest and authentic people. The

0:43

aim is to have you feeling lighter,

0:46

more supported and more understood after every

0:48

listen. Now, we can't promise

0:50

that it will always be kept PG, so

0:52

please be mindful around little ears. Here

0:55

we go. Hello

0:57

Jade. Hello Sophie

0:59

and all our bumpies listening. How are

1:02

you this week? I

1:07

think you can answer that for me. No,

1:11

I have absolutely nothing interesting to

1:13

report. I am on

1:15

my 72nd hour of this, this flow.

1:24

I honestly do not remember the last

1:26

time I was this unwell. I came

1:28

down with it overnight on Friday night.

1:30

I turned to Nick and I said,

1:33

can we

1:35

turn the heater on? It is fucking

1:37

freezing in here. And he was like,

1:39

babe, it's really not that cold. I

1:41

was cold to my bones. Like they

1:43

felt like they were cracking. They were

1:45

so cold. And

1:47

anyway, there's nothing more boring than

1:49

hearing people's sick symptoms. But

1:52

basically he left at 4am to

1:54

head to Brisbane airport to go

1:56

overseas for a week as I'm

1:58

there, like phrasing boiling phrasing. boiling.

2:00

But thank goodness I had already organised

2:02

for my mum to come up and

2:04

join us to hang out for the

2:07

week. And so she has absolutely been

2:09

just manning the fort of

2:11

the three kids while I have basically

2:13

been in and out of bed. She

2:15

has just been an absolute godsend. But

2:18

there's just, I hope she doesn't go

2:20

down. Don't I haven't even wanted to

2:22

let the thought enter my mind. So

2:24

thank you very much, Jade. But sending

2:27

solidarity out there to any parents who

2:29

are sick right now, because there's just

2:31

nothing worse than being a sick parent.

2:33

And as much as I've had my

2:36

mum here to help, it's just that

2:38

thing that no matter what state

2:40

you're in, most of the time

2:42

your kids just want you. And I

2:44

was in bed hucking up a lung,

2:46

like just feeling so miserable and sorry

2:49

for myself. And my kids were still

2:51

trying to crawl back into my womb.

2:53

So yeah, I'm just gonna

2:56

spend today as the last day feeling sad

2:58

and sorry for myself. And I hope that

3:00

tomorrow I can just pick myself up and

3:03

get back on with life. And I'm

3:05

gonna do that thing where for 24

3:07

hours you're like, I will never take

3:09

my health for granted ever again. How

3:11

good does the flowers smell and the

3:13

birds sound? And then within 24 hours

3:15

you're complaining about the same shit all

3:18

over again. But how are you? Alright,

3:20

I want to talk about something really serious.

3:23

And I need to get it off my chest,

3:25

because I think

3:28

that everyone deserves

3:30

to... Jesus, where's this

3:32

going? Yeah, I know it's pretty

3:34

deep. Can we just talk about for four

3:37

seconds or four minutes or four hours the difference

3:40

between mum, flu and man? Now,

3:43

my dear darling, dear husband,

3:45

I love him to be. It's all right.

3:47

Don't get me wrong. It's

3:50

great. Except when he

3:52

goes down with the same bug

3:56

as everybody else in the house. I just want

3:58

to make this clear right now. Now, man

4:01

flu is a proper illness. It

4:04

is dramatic. It is

4:06

emotional. No one has

4:09

it worse than them. And

4:12

it's just mind blowing. Like for

4:14

example, Mia has been

4:16

sick. I've had kids with whooping

4:18

cough, pneumonia, the whole works, right?

4:21

He gets a cough and I

4:23

shit you not. This is how it starts, the

4:26

aches start. And it's like, I'm

4:31

like, babe, I get it. You're gonna give

4:33

yourself an hemorrhoid. But

4:35

I'm like, can you just like, are there suffer

4:37

in silence or just tone it down a bit? Like,

4:40

you don't have to like, whoo. He's like, no,

4:42

I have to get it up, Jade. This is how

4:44

I have to get it up. I'm like, but

4:46

I've seen other people in the world cough and they're

4:48

not that dramatic anyway. Then he gets the shivers

4:50

and he's on in a fetal position on the couch,

4:52

like rocking back and forth. Oh, no. No,

4:56

no, no, no. And you're like, just go to

4:58

bed and be out of my sight. Are you

5:00

ready for this one? This is what taught me

5:02

off. Okay, babe, it's

5:05

like two o'clock in the afternoon. Have you taken

5:07

like your Panadol and urethane? Like you're on to

5:09

day five. You should know that that's what you

5:11

can do now to help yourself out. No,

5:14

like a hero in the army. He's like,

5:16

I just, I've been

5:18

soldiering on. I just haven't had anything since 9

5:21

a.m. I'm like, what

5:23

the actual fuck? Like, just

5:25

take it. I don't

5:28

need to see you being upset,

5:30

emotional, dramatic. Then he comes

5:32

to me at some time in the morning,

5:34

right? Wakes up and he's like

5:37

drooping. He's drooping in sweat. He's hunched over

5:39

and he goes to fucking cuddle me and

5:43

sweat comes off him onto me. And

5:45

I'm like, whoa, whoa, whoa. I

5:47

get it. I get what you're

5:50

doing. I see that you have sweat

5:52

all night. However, you don't need

5:54

to touch me. Just go

5:56

and have a shower, take it off, come out

5:58

and say, babe. I've sweat

6:00

all night, maybe three times, four times,

6:03

and I could tell, what can I

6:05

do for you? I don't need the

6:07

dramatization, no one does. If you are

6:09

parenting already sick kids, a

6:12

guy with some serious condition, which is literally

6:14

the common cold, like everyone else, and don't

6:16

get me wrong, he has been sick. It's

6:18

probably the flu. They've had it for 10

6:20

days. It's awful, terrible. But then I see

6:23

him at the sucker when he's starting to

6:25

get better, and he's yelling on the field

6:27

at Billy, go, bit. And I'm like, mate,

6:29

you've just lost your voice. Like,

6:31

help yourself out. Anyway,

6:33

I'm over it, I'm over it. He's

6:36

back on board, so I'm okay. Thanks

6:39

for asking everyone. I am okay. Jade's

6:42

okay. Oh my God, I've really

6:44

been like, I can't. I like, I need, I

6:46

had E-plugs. I just popped them in, because I'm

6:48

like, I can't deal with it anymore. I bumped

6:50

into someone I know whose husband

6:53

has also been suffering from a serious

6:55

case of the man flu. And he

6:57

was refusing to take Panadol and Urofen

6:59

as well, because he

7:02

didn't want to put that in his body.

7:04

And she's like, mate, I used to go

7:06

to da clubs with you, and I know

7:08

the shit you used to put your body

7:11

through. And she's like, you still vape. Just

7:13

take a fricking Panadol. Like, mate,

7:15

can we not, can we just get off

7:17

our high horse for a second so I

7:19

don't have to hear your bloody whinging? But

7:22

I laughed so hard halfway through the weekend,

7:24

because Jade had been on a roll about

7:26

how little sympathy she had for

7:28

the man flu. And she messages me halfway through

7:30

the weekend going, hey, I just want to

7:32

let you know, I do feel really bad

7:34

for you that you're sick. And it's different

7:37

because you're a mom, not a man. And

7:39

are you okay? And is there anything I can

7:41

do to help you? Like she

7:43

felt so guilty. And I was

7:45

like, Jade, I am so unwell that I think

7:47

I actually do have the man flu. That's how

7:49

bad it was this strain. Oh,

7:52

it's absolutely awful. But can I ask a

7:54

question to the bumpies listening? What

7:56

would be worse? A, your

7:58

husband is not a man. This

8:00

doesn't include you Sophie, because you're

8:02

actually sick and he is away.

8:05

So A, he's away overseas, right?

8:07

And you don't have to deal with him. Or

8:11

B, he is home

8:13

with Manflu. No, no, it's better when

8:16

your partner's just away. And

8:18

that's what I've really struggled with that

8:20

in the past, because I

8:22

really struggle when there's someone there who's

8:24

not helping. And Nick has actually

8:26

said to me before, he's like, you

8:29

are making me feel good. I feel

8:31

like such an inconvenience because I'm sick.

8:33

He's like, I can't help the way

8:35

that I'm sick. And I'm like, I

8:37

get that. I understand. And

8:39

I'm trying with every fiver of my

8:42

being to have just the slightest bit

8:44

of empathy and compassion. But if someone

8:46

cannot help me, I would rather, they

8:48

would just not be a first place.

8:50

But you know, the poor thing, the

8:52

poor prick, I am like day 10.

8:55

And you will listen to this in

8:57

this episode where I turn on day

8:59

10, I get really hormonal of your

9:01

cycle. Yeah. And

9:03

anyway, it's in this cycle. I put all the

9:06

shopping in, right? And then I hand, I think

9:08

I handed him lunch or something. No,

9:10

I don't know what I did. I think I just, I

9:12

don't know. I just wanted something from him. And I'm like, oh,

9:14

I've done all that. I've done this. And

9:17

he didn't say thanks. And

9:19

I was like, sorry, did I not get a

9:21

thank you? And he was like,

9:23

what? Because he's sick. He's like, oh, babe,

9:25

I didn't. And I was like, nah, nah,

9:27

don't, don't even worry about it anyway. I

9:29

just went off my tits because he's sick.

9:32

He doesn't care. He doesn't appreciate. And this

9:34

is all what I'm telling myself in my

9:36

head. But my God, it is

9:38

a journey. Winter is

9:41

hectic at the moment. So if you're out

9:43

there and you are dealing with a man

9:45

with man flu, I

9:47

feel your pain. And if you're like me

9:50

and you're dealing with the flu, I feel

9:52

your pain. Maybe even

9:54

slightly more than just. Yeah.

9:57

Yeah. And

9:59

if I go down. Everyone is not

10:01

going to give one Iota because I have just

10:03

been punishing everyone. No, it's going to give a

10:05

fucking rat's house. Okay, so just

10:07

off the back of all that, because that's not enough.

10:10

I had a massive work week. There's

10:12

been a lot going on, Yumi, over

10:14

the weekend. And we know how four

10:16

and five-year-old brains work. It's a lot.

10:18

It's a challenge. Love them. But

10:21

this is what she wanted and still

10:24

wants and had a two-hour tantrum about it. She

10:27

wants orange hair. So plain and

10:29

simple, just wants orange hair. It's

10:31

the copper cowboy trend. Very kindle, gender

10:33

of her. She's out there

10:35

to get it. Now, I said

10:37

to her, plain and simple, absolutely. Usually I'd be

10:40

like, well, you can't because you weren't born with

10:42

it. But she saw someone that actually put conditioner

10:44

in the hair. So it was all over. I'm

10:46

like, all right, we'll have a look into it.

10:48

Sunday, I said, the trick where nothing's

10:51

open, I can't get it for you. Lost

10:53

her shit. Couldn't believe she wasn't getting orange hair. I

10:55

said, oh, look today. No, didn't care about that. The

11:00

other thing about this is the orange probably won't even be

11:02

shown even if I do get the conditioner because her hair

11:04

is almost like jet black. So that's probably

11:06

not even going to be shown. But

11:09

someone else wrote in and she said, mate, I feel you. My

11:13

daughter thinks she's got pink

11:15

eyes, not pink eye, pink-colored eyes. And

11:18

I've been telling her they're not. They're actually brown.

11:20

And she has been losing it. Don't

11:23

you tell me that I've got pink eyes.

11:25

I mean, she might need a color check.

11:28

But all in all, it is a lot. It's

11:30

been just the icing of the cake from

11:33

the end of the week. But we are

11:35

here this week having a fresh start. So

11:37

let's give our listeners a Rudolph

11:39

fabulous. Yeah, this one is

11:41

an epic Rudolph fabulous. I think

11:44

it was sent into our Beyond the

11:46

Bump Facebook page. I'm laughing already. I

11:49

just had to share a Rudolph fabulous moment

11:51

from early this morning. We thought our three

11:53

and a half year old was sound asleep

11:55

still in his bedroom. Hubby

11:57

and I were mid sesh and I

12:00

suddenly felt like I was going to

12:02

sleep. feel some extra weight on top

12:04

of hubby and I. Turns out our

12:06

toddler had waddled into our room. Thankfully

12:08

it was dark. He climbed on top

12:10

of my husband and I and says,

12:12

group hug and gave us a big

12:14

hug when usually he isn't the most

12:16

affectionate type kid. I was

12:18

stuck there and couldn't move and neither

12:20

could hubby. So he had to pry

12:22

him off us. Literally he was stuck

12:25

like glue. Be careful saying

12:27

stuck like glue in this situation. But

12:29

anyway, by saying he can

12:31

grab three jelly beans from the cupboard,

12:33

leaving us just enough time to detach

12:35

from one another and run to the

12:38

bathroom before he got back. And to

12:40

top it off, he found my lipstick

12:44

in the sheets. Honestly, not

12:47

how I pictured my

12:49

morning stuff. Absolutely fabulous.

12:51

So fabulous. I love it.

12:53

The group hug. It's like, oh,

12:56

you have no idea what's happening

12:58

underneath those blankets. Let's get into

13:00

today's episode. We spoke to the incredible

13:02

Dr. Priya Alexander. She is someone that

13:04

I've been following on socials for quite

13:06

a while. She is a GP and

13:08

just a extremely entertaining educator.

13:10

I always loved her content and

13:13

we decided to get her on

13:15

because Jade and I have both

13:17

found that we didn't know if

13:19

it was with aging or since

13:21

having kids or with consecutive kids.

13:23

We just found that our periods

13:25

and our cycles and that kind

13:27

of thing were affecting us a

13:29

lot more and in very different ways. And

13:31

I felt that when I was speaking to

13:34

other mothers out and about, I was feeling

13:36

like there was this same story coming up

13:38

time and time again, that people who used

13:40

to be able to deal with their periods

13:42

were now finding them really challenging. And we

13:45

wanted to get to the bottom of kind

13:47

of what's happening? Why is this happening? What

13:49

are our options and all that kind of

13:51

thing? And I feel like I learned so

13:53

much from this chat. Yeah, she is amazing.

13:56

Look, I've said in this, she's a bloody

13:58

triple threat. She is

14:00

so good at what she does in

14:02

every aspect of her life. Overall, in

14:05

this chat, I think that the biggest

14:07

takeaway is that if you have not

14:09

had a checkup in the last, say,

14:11

six to 12 months, please go and

14:14

do it. Just have a overall checkup

14:16

about your health, especially postpartum. I think

14:18

as we say in this, as mothers

14:20

and carers, we are so quick to

14:23

be like, oh, we'll put ourselves directly

14:25

down the bottom of the list. But

14:27

I think we, especially me, we need

14:30

to put us right at the top,

14:32

make sure that we are great, best

14:34

versions we can be, and

14:36

then deal with everyone else after that. So-

14:39

Speaking of, this kicked me up the butt to

14:42

go and have an appointment with my GP, and

14:44

now saying this again should kick me up the

14:46

butt to actually go and get the blood done.

14:49

Because the pathology slip

14:52

is still in my car. So I will go

14:54

do that now. No, I won't. I've

14:56

got the flu. I'm not going into a little cubicle with anyone. I'm

14:59

going to go back arm horizontal, babes. We hope you enjoy.

15:02

Hello, Dr. Priya Alexander, and welcome to

15:04

Beyond the Bump. I am so excited

15:06

to chat to you today. Before we

15:08

get started, can you tell our beautiful

15:10

bumpies a little bit about yourself and

15:12

what you do? So I am,

15:14

I think my most defining feature is that I'm a mum

15:16

of two. So I have lived a lot of the stuff

15:18

we're going to talk about. I've got an eight year old

15:20

daughter, a four year old son. I'm

15:23

also a practicing GP. So I work

15:25

in Richmond, in Melbourne. I see absolutely

15:27

everything in anything and it's awesome, but

15:29

exhausting. And then I kind of have

15:31

these kind of Beyonce persona is what

15:33

I call her. And I do some

15:35

other fun stuff. Like I've got

15:37

social media. I do some TV stuff

15:39

and I've written some books. So. Yeah.

15:42

Look at you. You're a triple threat. A triple

15:44

threat. I love it. So good. Now today, I

15:46

think we could literally talk to you about anything,

15:49

whether that be in the mum space, in the

15:51

GP space. We're going to break it down for

15:53

an hour. In the Beyonce space. We

15:55

needed to, yeah, narrow it down

15:57

to something that we could fit

15:59

beautifully into a. podcast episode and

16:01

we wanted to talk to you

16:03

about hormones and I guess more

16:05

specifically postpartum. You said that like

16:08

it was whore moments. We

16:11

don't need to make that joke. Everyone's heard that

16:13

joke. All right. We're being professional

16:16

women. You guys are. But we

16:18

wanted to speak about hormones and I guess

16:20

more specifically postpartum hormones. I think as women,

16:22

it's funny because Jade and I were actually

16:24

having this chat where we were like, when

16:27

was the last time you went and saw

16:29

a GP or a doctor like about yourself?

16:31

And I was having this laugh that I

16:33

think I broke my thumb in January when

16:36

I was skiing in Japan and I just

16:38

couldn't fit in a time to see someone

16:40

because then I was like, oh and then

16:42

I know they're going to send me off

16:44

to get an X-ray. So I didn't do

16:47

anything about it. And I think as women,

16:49

we're bad at this. And then I think

16:51

even more so once we become mothers. So

16:54

we wanted to kind of I guess, bring

16:56

the power back to us and be like,

16:58

let's take care of ourselves. We're

17:00

a generation I think that wants to

17:02

know more about our bodies, more about

17:05

our cycles, more about our hormones. So

17:07

let's do some learning today. Yes. Little

17:09

biology lesson. Can I say I struggle with this

17:11

as a parent as well? I just want to

17:13

acknowledge it can be really hard

17:16

when you're a caregiver to anyone, be

17:18

it little people, aging parents, anyone at

17:20

all, to go, actually,

17:22

I need the appointment for me. Unless

17:24

you're truly, you know, keeling over

17:26

with abdominal pain, vomiting, you

17:29

kind of put off the rectal bleeding or

17:31

the thing you felt or the skin lesion.

17:34

And that's when things can really, you know, you come

17:36

and present to me and things are really escalated. And

17:38

I go, wow, for six months you've had this, but

17:40

I understand you kind of go, I've got to get

17:42

the kids in their flu vaccine. I've got to do

17:44

this and this and I've got to organize this with

17:46

the schools and you put yourself laughed. So

17:48

I say to patients, put yourself at the top of

17:50

the to-do list. I literally just

17:53

had a therapy appointment and my therapist

17:55

said to me, Jade, when was

17:57

the last time you actually saw a doctor?

17:59

And I said, oh, I'm sorry. Oh, I

18:01

haven't seen one since last October because my

18:03

mental health is great. And she goes, that's

18:06

something not to be proud of. I said,

18:08

I was talking to her about the fact

18:10

that I have like a burning gut every

18:12

time I eat certain foods. And then I

18:14

was saying that I have, you know, a

18:16

big bloating in my stomach and there's a

18:18

few things. And she's like, okay, that's sort

18:21

of something that needs to be looked at.

18:23

And I'm like, yeah, but my kid has

18:25

pneumonia. I've got this going on. I'm okay.

18:27

I'm still sort of okay. And she's like,

18:29

go and book an appointment. And I think

18:31

it is a real reminder, especially in this

18:34

episode, if you have not even had a

18:36

checkup, book in to get checked up. I

18:38

haven't done my Pap smear. I've been a

18:40

naughty girl and I need to do all

18:42

these things. And I think that especially postpartum,

18:44

it can be so hard to know, well,

18:47

everything in my body has changed. Nothing

18:49

is functioning exactly how it was before.

18:51

So how do you know what you

18:53

can ignore and what you can't? And

18:55

we had this funny story last year

18:57

where I went to Bali and our

18:59

entire family got Giardia. And it wasn't

19:01

until my daughter was like, mum, can

19:03

you please take me to the doctor?

19:05

My tummy hurts. Then I was like,

19:07

you know what? My bowels haven't been

19:09

normal for months as well, but I

19:11

was just putting it down to like,

19:13

oh yeah, I'm postpartum, everything's weird. But

19:15

no, I was getting around with a

19:17

fricking parasite that could be very easily

19:19

cured. And so do you know the

19:21

other one I see is rectal bleeding?

19:23

Like it being really serious for a

19:25

minute. I see so many parents postpartum

19:27

who go, well, I've had a pregnancy

19:29

and I just have hemorrhoids. And they'll

19:31

just connect the dots, self-diagnose and go

19:33

bumble along thinking it's hemorrhoids. And I

19:35

always say to patients because I've seen

19:37

everything now, don't assume,

19:40

don't make the call yourself, especially just

19:42

going, well, because I've just had a

19:44

baby, my gut changes, my rectal bleeding,

19:46

my lump in my boob, whatever it

19:48

is, we just go, well, I've just

19:50

been pregnant. Get it checked.

19:53

Don't assume anything's just normal. Let

19:55

someone else make the call. Someone

19:57

qualified. Let's hone

19:59

in on who. hormones though. So we're

20:01

postpartum, what can we expect hormonally and

20:03

what's happening in our bodies? I feel

20:06

like we constantly go, oh yeah, that's

20:08

a hormonal thing. But what do we

20:10

mean? What are we going through? We're

20:13

going through a lot. So,

20:15

you know, when you go through pregnancy,

20:19

then childbirth, regardless of what kind

20:21

of birth you have, be it

20:23

a vaginal delivery, a

20:25

C-section that's elective or an emergency

20:27

one, and

20:30

then what happens hormonally also

20:32

varies according to how you feed

20:34

your child. So if you exclusively

20:37

breastfeed, it means

20:39

that things like vaginal dryness postpartum

20:41

can be more pronounced. But

20:44

what is happening to your body is

20:47

a lot and that's what I

20:49

say to patients. I'm like during

20:51

pregnancy, you've got this estrogen progesterone.

20:53

It's high. It's supporting the pregnancy.

20:55

The progesterone is there to really

20:58

lay person, keep the uterus

21:00

quiet, comfortable during pregnancy,

21:02

a nice home for this growing baby. Then

21:05

after childbirth, everything just plummets.

21:08

Yes, it does. Yes, it does.

21:11

And if you're breastfeeding as well,

21:13

you're basically kind of postmenopausal, like

21:15

your estrogen levels are

21:17

low. And so what's happening

21:19

to your body? A crack load. And

21:21

so you might notice skin changes, vaginal

21:23

dryness, you get this kind of emotional

21:25

changes. You can be really, you know,

21:28

we talk about the baby blues, which

21:30

up to 80% of mums can

21:32

experience, which you might have lived.

21:35

That's, you know, we think multivacterial

21:37

sleep deprivation hormonal, but

21:39

heaps of stuff is changing.

21:41

And so skin changes, mood

21:43

changes, energy levels, heaps are shifting.

21:46

And it's a massive time in your life

21:48

where you go, well, my body

21:50

and my brain feel completely different. And hey,

21:52

I'm a permanent care give it to someone

21:54

24 seconds, but it's a huge shift. And

21:57

is that what leads to the hair loss

21:59

and why? does that seem to happen around

22:01

that four month, I mean, I know for

22:03

me all three times it happened around that

22:05

four month mark. And I remember when I

22:08

had my first child, because it didn't start

22:10

straight away. I was like, Oh, I'm one

22:12

of the lucky ones. I've still got my

22:14

lush pregnancy hair and then four months it

22:17

just hit me. And I just was shedding

22:19

in the shower. Why does that kind of

22:21

have that delay? So what happens during pregnancy

22:23

is because you've got really nice high estrogen

22:25

levels in particular, you've got more blood volume,

22:28

more circulating. Normally our hair

22:30

goes through cycles where it will grow

22:32

and you will lose hair. You're constantly

22:34

losing hair. They're in different phases of

22:37

growth. But during pregnancy, when

22:39

the estrogen is really high, the blood volume

22:41

is high, you've got more going around, the

22:43

hair gets retained. So you don't lose as

22:45

much. And so you have

22:47

these luscious locks whilst you're pregnant. And

22:49

regardless of the fact that you know,

22:51

you're urinating 50 billion times a day,

22:53

potentially in your pants, down your thighs.

22:57

Correct. Hopefully not going to

23:00

see a pelvic floor physio. And you've got all

23:02

these other things, but you're like, well, at least

23:04

my hair is good. But then

23:06

what happens is at around

23:08

four months, basically your hair

23:10

that has stayed

23:13

inside the follicles for those nine

23:15

months suddenly shed. And

23:18

it's not that you're shedding more,

23:20

it's just that you haven't shed

23:23

for about nine months. Yeah.

23:25

So many patients have exactly that response in

23:27

the consulting room. It makes so much sense

23:30

because I never have thick luscious hair unless

23:32

I'm pregnant. And I'm like, wow, look at

23:34

me. And then... Just a reminder, it's still

23:36

not worth it. No. And then you feel

23:38

like when it all comes out, you're like,

23:41

oh, what is this? But it's actually your

23:43

normal amount of hair. And you're like, oh.

23:45

It's your normal losses. So can you think

23:47

that people is, you know, it's not, there's

23:49

nothing fancy or sexy in terms of managing

23:51

it. It's trying not to heat style it

23:54

too much, trying not to brush over

23:56

wash. There are some

23:58

medical things that can. make

24:01

the hair loss worse. So

24:03

as a GP when I see patients

24:05

postpartum and they're presenting complaint with hair

24:08

loss, even though I know look

24:10

it's probably the four months normal hair loss

24:12

you're losing what you've retained during pregnancy, eye

24:15

deficiency, thyroid

24:18

disease which are more common postpartum

24:20

I have a low threshold to

24:22

check just in case because there's

24:24

other stuff that can cause excessive

24:26

hair loss. And what kinds

24:28

of things should we be getting checked

24:30

postpartum? Like there's a lot of talk

24:32

about balancing your hormones and these kind

24:34

of things like should we be coming

24:36

in you know down

24:38

the track and making sure

24:41

everything's functioning properly? Yeah can you get

24:43

a blood test? Well it depends. So

24:45

does everyone need a postpartum blood test?

24:47

No. We'd be jabbing a lot of

24:49

people and and also I always

24:52

say to patients because people are quite keen on

24:54

just getting a blood test and knowing which I

24:56

understand but if we're jabbing you

24:58

for no good reason, no clear clinical indication, we

25:00

run the risk of doing more harm. I say

25:02

this to people all the time. For instance

25:04

if you said to me today, let's just take

25:07

your blood and see, I would say I don't

25:09

consent because I know what

25:11

happens. You're gonna take my blood, I'm feeling bloody good

25:13

at the moment, I'm well, I'm exercising, I feel you

25:15

know as good as I can as a mum of

25:17

two in the full plate and you're gonna

25:19

jab me and you're gonna find something incidental that's

25:21

abnormal and then you're gonna lead me down the

25:23

garden path and go, well you live as a

25:26

bit abnormal, let's do an ultrasound, oh we probably

25:28

need a biopsy, then I'll probably have some complication

25:30

from the biopsy and that's

25:32

what we call the harm of incidentalomas and

25:34

why we should only do the rational test

25:36

ordering. So if someone says to

25:38

you and explains to you why you don't need

25:41

a test, that's the why, just to give people

25:43

that context. But when I do six

25:45

week checks and I do a pile of them for mum

25:47

and babies, I love them.

25:49

I will often at six weeks

25:51

recheck people's iron or B12 if

25:53

they were low during the pregnancy.

25:56

Some patients at six weeks need

25:58

another test for diabetes. If you've

26:00

had gestational diabetes, we need to do

26:02

another oral glucose tolerance test. If your

26:05

vitamin D levels were low during pregnancy,

26:07

we'd check that. So it really depends

26:09

case by case, but we

26:11

know that some things are more likely postpartum, like

26:14

thyroid disease, like iron deficiency after blood

26:17

loss during childbirth, particularly if you're breastfeeding

26:19

as well. And so I

26:21

might have a lower threshold to go, oh, do

26:23

you know what? You've just had a baby, you're

26:25

also super fatigued. That's probably sleep deprivation. But it's

26:28

a brave GP who says you're

26:30

not deficient in anything. So I just check,

26:32

best say. I've got a

26:34

bit of a personal question that I'm going

26:36

to mix in with a average general question.

26:39

Oh, I'm bumpy road in. So

26:42

I was going to say, how

26:45

can we balance our hormones postpartum?

26:47

I'm about five years

26:50

postpartum. And I have

26:52

this issue where 10 days

26:54

out from my period, I am

26:57

a raging

27:01

animalistic bitch. Like

27:03

I am, I'm out of control and

27:06

I'm not joking. It's like clockwork. I

27:08

get this real overwhelming

27:10

rush. I feel like it's hormones

27:12

or emotion. And I check my

27:14

app and it says day 10. So

27:16

then I have 10 days before

27:19

my period hits of spending time

27:21

with myself in this state and

27:23

my family going, oh, dear God.

27:26

Until you bleed? Until I bleed. As

27:29

soon as I bleed, I am the best

27:31

person. I'm back on track. Why

27:33

is this happening? Well you've got what

27:35

I've got, which is you've got quite severe PMS.

27:38

If not, and let's just nut

27:40

this out or PMDD. Now, we

27:43

need to be really clear here because I feel

27:45

like, you know, I've just done a podcast episode

27:47

with a guy in a college just unhappy to

27:49

health about stuff that we as

27:51

women or people who menstruate are told to

27:53

just put up with them and it's normal.

27:56

PMS is one of them. I feel like my whole life,

27:58

people just go to me. well, what do you

28:00

expect? You meant straight prayer? Like, you're going to get

28:03

a bit moody before your period. Now,

28:05

my husband has had a vasectomy. I'm quite

28:07

open about these things. Will's had a vasectomy.

28:09

We're not having any more children and I

28:11

am on the combined oral contraceptive pill or

28:13

the pill to put my ovaries

28:15

to sleep because I have

28:17

severe PMS. And does it help?

28:20

Oh, yes, it's the presence of the cycle but

28:22

can I be real nerdy and just because people

28:24

are listening and they might be going, what are

28:26

you talking about? What I think you're describing is

28:28

PMS which is you're telling me that you have

28:30

symptoms before you bleed in what we call the

28:32

luteal phase of your cycle. You

28:35

ovulate, you get these

28:37

symptoms. They can be physical for some

28:39

people, bloating, breast tenderness. It

28:41

can be brain symptoms,

28:44

irritability, teariness, anger, lots

28:46

of things. Some people have just physical. Some people have emotional.

28:48

Some people have a bit of both. I get a bit

28:50

of both. I'm both. And

28:53

it tends to settle with the

28:56

period starting. Hey, now

28:58

PMDD is a more severe version

29:00

of PMS and that is when

29:02

people can actually have significant mood

29:04

changes that make it hard for

29:06

them to function day to day

29:08

and I've seen patients completely debilitated.

29:11

Some people will actually have suicidal

29:13

thoughts during this patch and PMDD

29:15

is a very serious entity and

29:17

not as common as PMS. But

29:19

here's the thing. The reason for

29:21

PMS PMDD we think is multi-factorial.

29:24

Bit of hormones, lots of different

29:26

factors. So, I would say to

29:28

you if you were my patient, I would

29:30

say to you you've clearly tracked your cycle

29:32

and clearly this isn't an underlying mood disorder

29:35

because it's for day 10 to bleeding and

29:37

you've got a clear timeline

29:39

here and you must ovulate slightly early just but

29:41

I won't go into menstrual cycle history. It's true.

29:43

Yes. 26 days. There you go.

29:46

And so, I would say

29:48

to you, you've got options here. As long

29:51

as it's not PMDD, you can manage it

29:53

with lifestyle stuff. So, up the physical activity,

29:55

reduce the caffeine, the alcohol, increase meditation, more

29:58

rainbows, more fruit and veggies during the day. that

30:00

time and try and bump the lifestyle stuff

30:02

up. Right, you could

30:04

suppress your cycle. So, hey, let's put your

30:06

ovaries to sleep so you don't even ovulate.

30:09

And therefore you don't get the hormonal shifts.

30:12

So that might be with the pill if you're safe

30:14

to take it. Not everybody is. No, I'm allergic to

30:16

a lot of them. OK.

30:18

Or we say you could use

30:21

antidepressant therapy on a private script

30:24

only in your luteal phase. So from

30:26

when you ovulate to when you bleed.

30:29

So I've heard of this. Yes. So some of my

30:31

patients will take it too weekly. Then

30:34

they stop it because they're taking it sporadically. They

30:36

don't get all the side effects. It

30:38

doesn't cost as much either because you're not using it

30:40

every single day. And I've

30:43

had no I can't count the number

30:45

of patients who've come in, hugged me

30:47

in tears and gone. My life has

30:49

changed. I have this outrageous. We have

30:51

not been able to answer this question.

30:53

I have this outrageous urge to drink

30:55

alcohol in this phase. It is like

30:57

I crave it and

31:00

I will always I don't drink red until

31:02

I am in this phase. And I'm like,

31:04

I would have the whole bottle. Like I'm

31:06

like, please, I need this. Yeah. And it's

31:09

just I don't know what overrides

31:11

me, but it's like my body just can't

31:13

handle it anymore. And I'm like, this is

31:15

what I need. And then I feel like

31:17

a piece of shit for a few days.

31:19

I get my period and we're good. So

31:21

really, I feel like I only get three

31:23

weeks of quality me. And I

31:26

said to patients, and why do we accept that as the norm?

31:28

Why should we? I don't.

31:30

I'm like, why would I feel like a

31:33

crap mother, wife, daughter?

31:35

I lash out at everybody. You know,

31:37

I would almost if I was your

31:39

GP, I would ask you a billion

31:41

questions to see whether or not your

31:43

severe PMS or even PMDD. I would

31:45

knock that out. But I

31:48

would say to you, you've got options for

31:50

management. Why don't we take them? And

31:52

this gets back and this is why it's so important.

31:54

But it gets back to us as mothers

31:57

and people caring about ourselves going.

32:00

to the doctor because as I said,

32:02

the last time I cared for myself

32:04

enough to get checked out for all

32:06

of this was last October. Yeah. So,

32:09

I mean, it's just something that we have to do.

32:13

I don't remember the last time I

32:15

saw a doctor that was not for

32:17

something pregnancy related. And my youngest is

32:19

now 15 months. It's crazy.

32:21

Wow. Yeah. And

32:24

I have an appointment actually booked

32:26

in in a couple of weeks because...

32:28

Ooh. This was another reason I wanted

32:30

to chat is I am someone who

32:33

has... And this is not

32:35

meant to be a flex because I know there's

32:37

people out there who have had challenging periods from

32:39

the day they got it at nine or whatever.

32:41

But I have always been like, hasn't

32:44

really affected me in terms of PMS,

32:46

never really had pain, never really that

32:48

heavy. Following the

32:51

birth of my third child, I think I got it back

32:53

at about 10 months. It

32:56

has rocked me. I get that

32:59

stabby PMS feeling where I'm just

33:01

like, why do I feel stabby?

33:03

Why is the whole world so

33:06

irritating? And I get this

33:08

weird thing where on the first day of

33:10

my cycle, I get a

33:12

cracking headache and I end up vomiting

33:15

and I feel like how I feel

33:17

when I'm pregnant. And it is almost

33:19

like this because I've had high premises

33:21

three times. It is almost like this

33:23

PTSD thing where I know I'm not

33:25

pregnant because I'm in my first day

33:28

of bleeding, but I am pretty much

33:30

not functioning. And I've gaslit myself into being like,

33:32

but it's just for one day and you've just

33:34

got to get through the first day of your

33:37

cycle. And my husband turned to me and he's

33:39

like, yeah, but it's every month. It's

33:41

a day every month where you are

33:44

beside yourself so sick. Anyway, so

33:46

I've made an appointment because I

33:48

think that similarly my husband has

33:51

had a vasectomy. So I

33:53

was like, oh, well, I don't need to go on

33:55

contraception, da, da, da, but I'm like, maybe

33:58

hormonal contraception. for

34:00

not contraception reasons could actually

34:02

help me. But then

34:04

I guess another question we've had is the

34:07

pill and other hormonal contraception

34:10

have such a bad reputation

34:12

nowadays that I'm

34:14

almost scared to endorse it or like

34:16

say that I'm keen to try it

34:18

because you hear so many negatives. So

34:20

does it deserve the bad reputation or

34:22

is there still a place for it?

34:24

Of course there's still a place. So

34:26

this is where, look, I think social

34:28

media has lots of pluses, okay?

34:31

Look, we have to be honest, there's pros and

34:34

cons to bloody everything. But

34:37

one thing social media has done that's

34:39

really negative in the health space is

34:41

it's allowed disinformation

34:44

and misinformation to just

34:46

spread like wildfire. And

34:49

fear mongering when it comes to health

34:52

is very possible now. And

34:54

I have seen that with social media, the number of

34:56

patients who come into me and go, prayer, do I

34:59

have to come off the pill? Cause I saw this

35:01

person who said this and I'm like, what person have

35:03

I missed something from the medical literature? No,

35:06

I haven't. This is just

35:08

someone sharing their anecdotal story.

35:11

You know, I took the pill and

35:14

I noticed that it impacted my mood.

35:17

Now, sure, you can share your story

35:19

but what people do is therefore the

35:21

pill is bad for everybody because it's

35:24

bad for your mood. And

35:26

that's where it's dangerous. And that's where I

35:28

find I have to undo a lot of

35:30

stuff as a GP in the consulting room

35:33

to go, where have you heard

35:35

this? This person's not qualified.

35:37

That's one person, sure it's a listed side

35:39

effect but it doesn't mean that everyone gets

35:41

it. And so it

35:44

really, really, I find it like really

35:46

problematic how much people can kind of

35:48

spread myths or just

35:50

their own experience and generate this

35:52

fear amongst people because absolutely things

35:55

like the pill or intrauterine

35:57

devices or implantable devices. can

36:00

change people's lives in a positive way.

36:03

And it's not just about contraception. So

36:06

heavy vaginal bleeding, amazing. Intrauterine

36:08

device or the pill. The

36:10

people with endo and adenomyosis,

36:13

hormonal contraception can change their

36:15

life. You

36:17

know, debilitating pain, pain during

36:19

intercourse, chronic pelvic pain, it

36:21

can change their life. I've seen it. PMS,

36:24

people who get hormonal migraines sometimes,

36:26

you know, these things have a

36:29

place and what I say to people is, one

36:32

thing won't work for everybody. You

36:34

know, I love the combined oral contraceptive pill for

36:36

me. For me, the benefits outweigh the risks. It

36:39

doesn't for everyone. Some patients say it in their

36:41

prayer. My libido goes to absolute

36:43

shit on the pill. I'm not happy to

36:45

try. Let's try another one or let's try

36:47

an intrauterine device. For some people, the intrauterine

36:50

device, the thought of the procedure, having

36:52

it inserted scares them, fine. For some

36:54

people, they might get erratic bleeding with

36:56

an intrauterine device. But I can tell

36:58

you, I've got so many patients who

37:01

go to mid-preer. I don't bleed

37:03

with it. 60% of people don't bleed

37:05

with an intrauterine device at 12 months. I

37:07

suddenly don't have pain and I don't have to take

37:09

a pill every day. Happy as Larry. We'll

37:12

be back in a minute with more

37:14

Beyond the Bump Goodness after this short

37:16

break. Jade, you know how I'm always

37:18

on the hunt for the comfiest, most

37:20

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37:22

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37:24

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37:35

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37:39

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37:41

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back to the

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38:56

See her lines aren't restricting

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how comfy they are. So

39:06

if we wanted to get our hormone levels

39:08

checked, what stage in our cycle would we

39:10

be best to come and see a GP

39:12

to do that? So my question would be,

39:15

why do you want to get your hormone

39:17

levels checked? Cause I wouldn't normally do it

39:19

in someone who's well with a regular menstrual

39:21

cycle. I'd go, what

39:23

are we looking for? Well, yeah,

39:25

I would, for me personally, because

39:27

I'm outrageous at that 10 day

39:30

mark, I am

39:32

sort of questioning, am I

39:34

like the drop in progesterone or

39:37

estrogen, that I'm, am I lacking

39:39

in that? And that's why I

39:41

go from normal to absolute hell.

39:44

So that probably won't answer.

39:46

So normally with things like

39:48

PMS, even PMDD, it's

39:51

a clinical diagnosis. We don't need the biochemical

39:53

markers for it. If

39:55

I was thinking, all Jay, do we need

39:57

to exclude the fact that there's nothing else

39:59

going on? here like a thyroid disorder or

40:01

iron deficiency because you're also feeling fatigued, I

40:03

do those bloods. But here's

40:06

the thing, even if I tested things

40:08

like your progesterone, your estrogen, your FSHLH,

40:10

which sometimes we do if I suspect

40:12

maybe you've got PCOS or maybe you've

40:14

got premature menopause or ovarian failure, sure.

40:16

But in that setting, it's not going

40:18

to change my management because even if

40:21

they're normal, I know

40:23

there's something going on for you that's

40:25

not normal. It doesn't change my management.

40:27

Right. Yeah, from your story,

40:29

it is so obviously cycle related.

40:32

Correct. Like who cares

40:34

what your levels are. Yeah. Right.

40:37

And there's nothing pathological in terms of you're not saying

40:39

to me, Priya, I'm not getting a period at all

40:41

for six months. Because then I'd go, oh, is it

40:43

PCOS? Is it premature ovarian failure? And

40:45

then I do all the bloods,

40:47

the clinical guidelines, some chickens, 17-hydroxyprogesterone,

40:50

prolactin, all of it. But

40:52

for this, it's not going to change

40:54

my management. If you're progesterone is normal,

40:56

it's not going to make me go,

40:58

okay, Jade, see you later. Catch you

41:00

in five minutes. You're fine. No, that's

41:02

so true. Go via, yeah, gutted gumbling

41:04

for the next 10 days of every

41:06

month. It's almost like as a woman,

41:09

right? Because we get told about PMS,

41:11

it's almost like brushed off, like, oh,

41:13

but everyone gets PMS. So

41:15

when I have PMS and as

41:17

I've had three kids and I've

41:20

gotten older, my period pain and

41:22

all my symptoms have actually gotten

41:24

worse. I now think if

41:26

someone says it's PMS, I'd be like, oh

41:28

no, but everyone gets that. So it's

41:30

like, I don't believe that PMS, like it's

41:32

not as significant as it is. And

41:35

you're saying it is. Yeah, that's because, and

41:37

I think that's a societal problem. I think we led to

41:39

believe that it's normal and that we should put up with

41:42

it. Just because lots of us have

41:44

it doesn't make it normal. And

41:46

I always say this to patients, I wasn't willing

41:48

to put up with it. And it took me

41:50

years to get there to actually go, guess what?

41:52

I've actually realised that I can't manage this with

41:54

the lifestyle interventions and I'm actually starting to notice

41:56

an impact on my relationships. And

41:59

it's not a cop out. for me to say I

42:01

need a bit of extra help because what's happening

42:03

to me isn't normal. Like period

42:06

pain as well. We're led to just

42:08

believe because we meant straight we've got

42:10

to put up with all these things.

42:12

No. And honestly I get like because

42:14

I have you know anxiety and depression

42:16

that's actually in my system but I

42:18

also find myself getting to like day,

42:20

I don't know, we're three days out

42:22

from a period and I'm looking at

42:24

the app going for fucks sake like

42:26

how long have I waited it feels

42:28

like I have been infuriated forever and

42:30

I've still got three days. But I

42:32

bet day 10 comes around

42:34

mighty fast. Like with mine happening on

42:36

day one I'm like how has it

42:38

already been a month? We can't be

42:40

here again already. And I'm happy on

42:42

my period that's my happiest ovulation and

42:45

period is when I'm like oh

42:47

yeah. So you can feel better for

42:49

a longer period of time. I

42:52

think sometimes good to know. It's good to know.

42:55

It can be different and guess what

42:57

you've got options hormonal ones and

42:59

non-hormonal ones and you can do

43:02

what suits you. Do you find

43:04

that often you know as I

43:06

was saying before that pre-kids and

43:09

even pre-three kids I found periods

43:11

very manageable. Do you find that

43:14

after women have kids these symptoms

43:16

do get worse and they get

43:18

worse with the more children you

43:20

have? Or am

43:22

I just like I cannot handle anything else?

43:24

Well I think look I think a couple

43:26

of things in that. We know that the

43:28

body changes. So some patients go to me

43:31

and say what's going to happen to my

43:33

period postpartum and I go I don't know

43:35

because for some people it gets better, for

43:37

some people it gets heavier. You've got to

43:39

remember the body even without pregnancy changes as

43:41

we age. Yeah. So even

43:43

in my patients who are 40 who've

43:45

never had a pregnancy notice changes in

43:48

their cycle. The endometrial lining shifts, you

43:50

know hormonal shifts, lots of things. And

43:53

so what's going to happen to your

43:55

menstrual cycle, the heaviness, the pain, the

43:58

PMS? It's a gamble. anything

44:00

could happen. But I do say

44:02

to patients, once you've got kids, and three in

44:04

particular, like I've got two, that's enough, but once

44:07

you've got kids, your threshold, or your propensity

44:09

to be able to put up with stuff,

44:11

because you're sleep deprived, suddenly you're

44:13

a caregiver. I can't be, you

44:15

know, killed over in pain for a day. Like,

44:18

well, that was fine before, but your

44:20

threshold declines for a lot of

44:22

people. But I do say to

44:25

people, I can't predict what's gonna happen,

44:27

and I've seen it all. People who've

44:29

stayed the same, gotten worse, gotten better, it

44:31

can all happen. And cause isn't that

44:33

what a lot of women with endometriosis are told?

44:36

That it's like, oh, if you get pregnant, it'll

44:38

be better after that. But

44:41

as you're saying, it could go one

44:43

way or the other. Well, not necessarily

44:45

after, during pregnancy, because you're not ovulating

44:48

and bleeding. Yeah, shortness like endo and

44:50

adenomy. Yeah, but you

44:52

can't be pregnant your whole life. And

44:54

so yes, we know that those symptoms

44:56

can get better with pregnancy, but they

44:58

can certainly flare postpartum. Once you start

45:00

bleeding again, and having the

45:02

cycle shift, things can return.

45:04

Now, how long does it take

45:07

for your cycle to return to

45:09

normal postbaby? Normal. We're gonna,

45:11

in quotations, normal. None of us are normal.

45:14

We're gonna talk about factors like

45:16

breastfeeding and hormones. So it can

45:18

vary. So people's cycle can return

45:20

for the six week postpartum. I've

45:23

seen that. Yeah, I have a

45:25

friend and she exclusively breastfed in

45:27

both times that came back four

45:29

weeks postpartum. And she's like, this

45:31

is the most unfair

45:33

thing I've ever experienced. That

45:36

is unlucky. Because a lot

45:38

of people will actually rely, like when I do

45:41

a six week check, I always talk about contraception,

45:43

because it's part of our job to help people

45:45

with family spacing and ensure, yeah,

45:47

reduce the risk of all pregnancy outcomes for

45:49

mum and baby by talking about family spacing.

45:51

So that's why I talk

45:54

about contraception. But some

45:56

patients will rely on lactation or amenorrhea,

45:58

which is this kind of. of

46:00

notion of exclusively breastfeeding, you've got a baby under

46:02

six months, you don't have a gap of more

46:04

than four hours, and you've got

46:07

to satisfy certain criteria. But one

46:09

of the criteria is you don't have a return of a

46:11

period. So your friend is

46:13

unlucky with the return of a period, because a

46:15

lot of people can just breastfeed

46:18

exclusively, not have a period, not have

46:20

a long gap and use that as

46:22

their contraceptive method. It's not foolproof, by

46:24

the way. But return

46:26

of cycle is a funny thing. So

46:28

some patients might not have return of

46:30

cycle, even if they're not

46:32

exclusively breastfeeding for kind of six to

46:34

nine months. Others will be much longer.

46:36

So we can't say when your period

46:39

is coming back for some

46:41

four to six weeks, for others it

46:43

might be later, six to nine months.

46:45

I've got a question for you. Can

46:47

you get pregnant with a

46:50

egg release before your period comes?

46:52

Or do you have to have

46:54

your period first while breastfeeding or

46:57

during this time? And

46:59

then it's an indication that you'll fall

47:01

pregnant. So if you're bleeding, it often

47:03

means that you've ovulated proceeding. Okay, so

47:06

you have to- You can get pregnant-

47:08

Yes. Before your period starts.

47:10

Before you've ever had a period. You could, yes.

47:13

Okay, good to know, because I just think

47:15

that is something that we should be highly

47:17

aware of. Yeah, so you could flick off

47:19

an egg. So what I say to patients

47:21

is if you're suddenly dropping back breastfeeding or

47:24

having larger gaps, you

47:26

need to be aware that suddenly the

47:28

ovaries might wake up from their slumber.

47:30

This is how I talk in the

47:32

consulting room. I like it. And pop an egg off.

47:35

And so as that egg, just

47:37

remember that the egg has a 24 hour

47:40

lifespan. It doesn't have that three to five

47:42

day lifespan that sperm do. But

47:44

whilst that egg is alive for 24 hours, sure,

47:47

if you had unprotected sex, there is that

47:49

20% chance per cycle that

47:51

you might conceive. So, but we

47:53

don't want to horrify people. No,

47:55

we don't. But yeah, pregnancy, you know, as a

47:57

JEP, we learned that- you

48:00

know, most things can be pregnancy unless it's excluded

48:02

with a test. And that is why I have

48:04

a very low threshold because, you

48:07

know, pregnancy can be the great masquerade

48:09

of symptoms, fatigue, breast cancer, anything. Now,

48:12

speaking of we've touched on contraception,

48:14

I guess already. And I think

48:17

a lot of people want to

48:19

know postpartum, what are their contraceptive

48:22

options? I guess you've said, what

48:25

is it, lactational amenorrhea? So using

48:27

the fact that you're exclusively breastfeeding,

48:29

you're not having a cycle. I

48:31

guess that's one end of the

48:33

spectrum. What are other options?

48:36

So in my book Eat Sleep, Play Love, anyone

48:38

listening who's going, what can I use postpartum? There's

48:40

a beautiful diagram in there where I break it

48:42

down for people and all the things to consider

48:44

because it's a very nuanced discussion. There's a personal

48:46

preference that comes into it. There's lots of factors.

48:49

But lactational amenorrhea is one option. So at

48:51

the six week check, the main things I

48:53

talk about with people are they

48:55

can use the breastfeeding as

48:57

contraception. It's not foolproof. Condoms,

48:59

if you've got a male partner, the

49:02

only proviso I give to that and

49:04

there's a few is that vaginal dryness

49:07

is a serious thing postpartum. And

49:10

you're going to need lubricant. And if you're

49:12

using condoms as your contraception, it's got to

49:14

be a water based lubricant. So the condom

49:16

doesn't thin and weaken and therefore

49:18

break. Key, key part of info.

49:20

The heaps of my patients at six feet

49:22

actually go prayer. I just want to

49:25

rock out with condoms for now. Totally fine. Rock

49:27

out. And I'm like, yeah, go. The other

49:29

thing, because we use condoms for a while

49:31

before Nick went and got the snip, and

49:33

I will say one downside of it is

49:36

when you're having sex as a parent,

49:39

you've got to get it where you can get it. Yeah. And

49:41

you're just like it just slows the whole

49:44

process down. And I'm like, we have a

49:46

finite window here. And I that thing needs

49:48

to go on because I'm not getting pregnant

49:50

again. But really

49:52

slows down things that need to. I

49:55

know. Hurry up and happen because the window is

49:57

small. And that's one thing

49:59

people say. And particularly if you're

50:02

someone or a couple who have

50:04

sex sporadically and randomly, patients

50:06

go to me, I'm not going to put

50:08

the condom on. If we're in the laundry

50:10

and the kids are in bed and I'm

50:12

like, well, then it's not for you. You

50:14

know, sex is important. Just scatter them around

50:16

the house. Stick them to your forehead. Yours

50:18

would be in the pantry, wouldn't they? I

50:20

would be everywhere. I actually thought of the

50:22

pantry. That's right. But it is important. Sex

50:24

is an important part of relationships. And that's

50:26

something that a lot of people feel really

50:28

changes and shifts in that postpartum patch with

50:30

their partner. And so I said, you know,

50:32

sex is still important. It's about finding out

50:34

what feels good again, making sure that, you

50:36

know, we don't have an unplanned pregnancy. So

50:38

it could be condoms. We also

50:41

often use the progesterone only pill. And

50:44

that's something that I often offer at six weeks. It's

50:46

a bit of a bugger to take. I'm going to

50:48

be honest, because you have to take it within a

50:50

three hour window every day. And

50:52

then you've got intrauterine devices as well, which we

50:54

can talk about at the six week mark. And

50:56

lots of people love that, particularly if they know

50:59

they're not going to have kids in the next

51:01

five years or they know they're done and they

51:03

just want to have something set and forget. If

51:05

you're breastfeeding, those are the main things that we

51:07

offer because we know that they're not going to

51:10

impact milk supply in the first kind of postpartum

51:12

patch. If you're not

51:14

breastfeeding or we're later down the track,

51:16

it opens up everything, including methods that

51:18

contain estrogen like the combined oral contraceptive

51:21

pill and all the rest. I

51:23

should say the implantable device as well with progesterone is

51:26

also an option. I just don't have many people use

51:28

that at the minute. I don't know why. But

51:31

you've got so many options. There's a platter,

51:33

a plethora. Also, I mean,

51:35

we've done a whole episode on vasectomy

51:38

before, but just in case someone's listening

51:40

who hasn't, how does

51:42

someone go about getting a vasectomy and

51:44

what kind of procedure is that in

51:46

terms of the

51:48

scariness? I

51:51

actually didn't say permanent method, sorry. I should

51:53

have said you can get tubal ligation as

51:55

a person who menstruates, which is basically the

51:57

tubes, so the little knee can't get down

51:59

the fallopian tube. or vasectomy, which is essentially

52:02

where they cut the vas deferens, so the

52:04

tube that carries the little swimmer's, the sperm

52:06

from the testicle out through the penis. Is

52:09

it scary? No, it's a day procedure. So

52:11

some people go and get it under light

52:13

sedation, some people go and have a general

52:15

anaesthetic. It is, you know,

52:18

excellent for lots of people, myself

52:20

included. I can talk about this

52:22

really personally. You know, once we've

52:24

got that. I think all three

52:26

of us have been very happy

52:28

with the outcomes. And do you

52:30

know what else it is? It's

52:33

also good because it's like, I feel

52:35

like we've had periods, you know, most

52:37

of our lives, we've been pregnant, we've

52:39

carried our children, we've birthed our children.

52:41

If you could kindly just go and

52:44

do something, you know, and snip your

52:46

bits off so we can continue. That

52:48

would be awesome. No bits, come on. Yeah, I think

52:51

that needs to be safe. Don't worry. Yeah, don't listen

52:53

to me. I'm a professional. People bring

52:55

out exactly a very minor procedure. You

52:57

can get a reversal done, you know,

52:59

the success rate can vary. But like

53:01

I say to people, if

53:03

you are fairly certain that this is your

53:05

family and it's completed, it can

53:08

be a really nice option. You need

53:10

to be careful though that you do

53:12

follow the strict rules of additional contraception

53:14

for three months, because swimmers can

53:17

still be released and that you go and

53:19

get the test, the semen analysis done at

53:21

the end of three months to make sure

53:23

there's no swimmers. Because I've seen people with

53:25

pregnancy and they never did that test or

53:27

they didn't use condoms in that three month

53:29

period. Jade's husband never went with him, got

53:31

the test. We never checked, but we do

53:33

have sex when I'm ovulating and so far

53:35

so good. So okay, I would still just

53:37

go get it done. Really? Yeah.

53:40

Really? Because I'm like, we are trained to

53:42

go, you don't know unless you know. That's

53:45

true. Oh, that is true. How do you know? Like,

53:47

I would make. Well you just don't. The amount

53:49

of sex you guys are having nowadays now that

53:51

you're on your spicy novel train. I should have

53:54

triplets. I think it needs to go and get

53:56

checked. The spicy novel train is great. How

53:59

good is it? It's the best time

54:01

of my life. I prescribed it to a glacier in the 40s.

54:04

Fuck yes. Yeah. I know,

54:06

and because I've never been, I've never enjoyed porn.

54:08

I've never liked any of those things. And my

54:10

husband loves it now. He's like, what kind of

54:12

book are you reading? And I'm like a thriller.

54:14

And he's like, oh, Dan. And the next time

54:17

it's like, what's this next book? And I'm like,

54:19

it's one you'd like. And he's like, fabulous. Like

54:21

it is, like it should be prescribed out there

54:23

to help with libido. I'm so glad you do.

54:25

Because I can be reading one book that has

54:28

cowboys. And I'm like, honey, can you go get

54:30

your cowboy hat? And he's like, yep. And then

54:32

the next minute, he's got a mustache at the

54:34

moment because I've been reading someone that has a

54:36

mustache. I've been really into it. Now he's walking

54:38

around out there with a mustache and he's having

54:41

the time of his life because he knows what

54:43

he gets. This is so funny. But do you

54:45

know, I did actually suggest to a patient the

54:47

other day, we were trying to get the libido

54:49

back and sexual relationship and they've been married for

54:52

a long time. And I said, go and buy.

54:54

I said, do you like fantasy? She

54:56

said, yes. And I said, go and

54:58

buy for sweet. I said, that's gonna

55:00

get things happening. That's what started it.

55:03

Yeah, there you go. But I do think, let's

55:06

just talk about libido for two seconds. Libido doesn't

55:08

come in second. It doesn't, people just think we

55:10

should be in two seconds. It can be hard

55:13

work to get turned on. We are

55:15

fatigued. It's the mental load,

55:18

particularly as primary caregivers. You're thinking about

55:20

a billion other things. Lots

55:22

of medical things can impact libido, medications,

55:25

depression, anxiety, thyroid, eye

55:27

deficiency. It is

55:30

a complex beast. And so

55:32

I said to patients, we can't expect ourselves

55:34

to just like, witch on and let's have

55:36

sex now. Two. You

55:38

gotta work on it. You gotta reconnect with people.

55:40

And I say to patients, even at the six

55:42

week check, they're like, we've got no sexual desire.

55:44

Maybe it's three months down the track. I'm like,

55:46

go and sit somewhere nice and talk

55:49

to each other with no screen. Once

55:51

the baby's asleep, talk to each other about the stuff

55:53

that you used to enjoy doing together. Go for brunch,

55:56

have a glass of wine at night, have

55:59

a bath together. It can take effort and

56:01

work. And also connect with yourself. Like I

56:03

think once you connect with yourself, you can

56:05

go, oh, like for me reading, I was

56:08

like, this is stunning. Like

56:10

I'm really enjoying this. And then all of

56:12

a sudden it's led to a

56:14

really good sex life again. And I'll

56:16

admit we didn't have a good sex

56:18

life for like a few years. I

56:20

was like, not interested. I just

56:22

can't get my head's not in the game. I'm tired

56:25

or I'm hormonal. It doesn't

56:27

always last forever. Well,

56:30

I just think that we need to acknowledge that

56:32

it can take time and effort and energy and

56:34

that the emotional connection can be really important for

56:36

a lot of people. And you need to actually

56:38

invest in that. And also

56:40

foreplay. Like these are the things I talk

56:43

about in the consulting room. Be that on

56:45

your own, be that with your partner. Postpartum,

56:48

finding out what feels good again. So

56:50

when Eat, Sleep, Play, Love, I've got

56:52

the pelvic floor physio, Melissa Leighton, who

56:55

offers kind of tidbits in there. But

56:57

actually knowing what things feel like

57:00

postpartum, because things feel different. Do

57:02

you still like stimulation around the

57:04

vulva and the clitoris or is

57:06

it more penetrative? Has things changed?

57:09

Are you even comfortable with that

57:11

area being touched? Have you looked

57:13

at it? Are you feeling

57:15

confident and comfortable? It's a

57:17

complex cat. So I think being open about it.

57:19

And I know people are talking about it more,

57:21

which is good. Cause patients will come to

57:23

me and go, we were talking about it at dinner with my friends.

57:25

And I'm like, awesome. Like, yes, let's

57:28

do something about it. I love this. I

57:30

can just picture you at your desk,

57:32

writing out a script for the fourth

57:34

wing and tearing it off and going,

57:36

okay, I'll see you in three to

57:39

four weeks. And here's a script for

57:41

some clitoral masturbation. And some water-based lube.

57:43

And I think I had this real

57:45

fear that my husband was going to

57:48

physically feel a big difference.

57:51

Like as though it would be, you know, the

57:53

old saying, throwing a sausage down a hallway. I

57:55

was just like, if a baby has come out

57:57

of there and now three, how? How

58:00

could you, I'm not saying he's

58:02

got a vindic, but how could you put that

58:04

in there? And it feel good,

58:06

but mentally- I don't know if he's just telling

58:09

me this to feel good. He's like, it feels

58:11

the same. But mentally, I've got to say, and

58:13

I agree with you mentally because you've burst. And

58:15

like, I'll admit, I put a tampon in and

58:18

it's got to be a jumbo, but like, I'm

58:20

just thinking- Yeah, but a jumbo tampon is just

58:22

smaller than a penis. Oh, these days, it's nothing.

58:24

It's nothing. It's tight and minuscule.

58:27

So I just think about it. I'm

58:29

like, I just had this idea in

58:31

my headpost, pardon, that it is literally

58:33

like a huge cave that

58:35

he's walking into. And he

58:38

was like- It's the same. So

58:40

don't forget the vagina. It's like

58:42

a beautiful tube, a muscular tube.

58:44

It has the ability to stretch

58:46

and contract. So

58:48

even if you've had a vaginal delivery and

58:50

a fetus has come through, sorry to imitate

58:52

the fetus. The vagina doesn't

58:54

just stretch and then stay like that. It

58:58

comes back. It's a beautiful

59:01

muscular tube. It's an

59:03

amazing thing. So yeah,

59:05

I always say to people who do actually say

59:07

this at Six-Speak Checks or earlier, like, I'm really

59:09

nervous about this. I'm like, that puppy

59:11

is designed to do this and it will come

59:13

back. It's a muscular wall. Are

59:15

some people tighter than others? Yeah,

59:17

well, the gyno, kind of your tone is

59:20

going to vary between people and it's also

59:22

dependent on things like your pelvic floor and

59:25

how tight that is. So we know in

59:27

some people, all the pelvic floor muscles, that

59:29

sling, the hammock of muscles that supports the

59:31

uterus, the bladder, the rectum, all of it.

59:33

In some people can be way too

59:36

tight, particularly if they've got things like

59:38

endometriosis and pelvic pain. Some

59:40

people who are quite anxious or worried can hold

59:42

tension in their pelvic floor. So

59:44

that can impact how the vagina

59:47

feels or how easy penetrative intercourse

59:49

or any penetration is. And

59:52

for others who can relax easily, who haven't had

59:54

issues with pelvic pain, it might be a different.

59:56

So yeah, it can vary amongst us. So I

59:58

think when I read my spicy blog. Sometimes I'm

1:00:01

reading these scenes and I'm like, I could easily

1:00:03

do that. Like everyone, this girl seems to be

1:00:05

struggling. I'm like, nope, nope, not for me. I

1:00:07

think I could be quite fine with all those

1:00:10

things happening. All those, all

1:00:12

those men. All those

1:00:14

men. Wow, you're bleeding all over. I can't. She's

1:00:17

not on fourth wing anymore. She's really... No,

1:00:20

I'm going to need to get some book

1:00:22

recommendations. Pucking around. It does not

1:00:24

puck around. So you should seriously read pucking around

1:00:26

as well. Maybe read it first before you prescribe

1:00:28

it to anyone. The person may not return.

1:00:30

They'll be like, wow, Dr. Priya

1:00:33

has some, has some things she's into

1:00:35

that I was, that were unexpected. Can

1:00:37

we finish off talking about perimenopause?

1:00:40

I feel like like all female

1:00:42

issues, it's only now kind of

1:00:44

starting to get the the

1:00:47

limelight it deserves. What's happening then?

1:00:49

And when can we expect it?

1:00:52

So just going back to basics,

1:00:54

average age of menopause in Australia is 51. Menopause

1:00:57

basically means that you've not had

1:00:59

a period for a year. OK,

1:01:03

and so you're no longer ovulating, you're no

1:01:05

longer menstruating. And if you've passed a year,

1:01:07

you've gone through menopause. Perimenopause

1:01:09

is essentially referring to that

1:01:12

whole time patch before menopause.

1:01:15

And it is really a time

1:01:17

when hormones like estrogen and progesterone

1:01:19

are fluctuating and it can

1:01:22

occur for people in

1:01:24

their 40s, any time in their 40s. And

1:01:26

what we're learning is that it's

1:01:29

actually a lot longer than for some people,

1:01:31

than what we probably previously appreciated as a

1:01:33

medical community. We're acknowledging that more and there's

1:01:36

lots coming out in our space. And

1:01:39

so what's happening is you're getting estrogen and

1:01:41

progesterone are starting to fluctuate a little bit.

1:01:43

A lot of people will say that their

1:01:45

periods are starting to just change lengths in

1:01:47

the cycle, change a little bit.

1:01:50

And the symptoms of perimenopause, much

1:01:52

like PMS, can be vast,

1:01:54

physical, emotional. So some

1:01:56

people go, pre-op, I'm suddenly developing skin changes

1:01:58

or I'm starting to know. I noticed some

1:02:00

bloating at this time, I'm getting this. Some

1:02:03

people will go, I'm irritable, my

1:02:05

fatigue, I've got brain fog. So the

1:02:07

symptoms can be really wide reaching. And

1:02:09

even if I tested someone's hormones and

1:02:12

they're normal, it doesn't

1:02:14

exclude perimenopause. And

1:02:16

so our job really, or my job as the GP

1:02:19

is to exclude that I'm not

1:02:21

missing anything, that your symptoms are something

1:02:23

like a mood disorder, depression, anxiety, something

1:02:26

else, that I'm not missing, a

1:02:28

thyroid disease or iron deficiency or something else.

1:02:31

And if I've excluded the other stuff

1:02:33

and I go, this is perimenopause, there

1:02:35

are options for management from lifestyle to

1:02:37

hormonal to non-hormonal. I would say to

1:02:40

people be empowered, go and find

1:02:42

someone who's gonna see you, hear

1:02:44

you and support you. Because

1:02:47

it's a very tricky time for

1:02:50

a lot of people. Is it

1:02:52

similar to other menstrual symptoms that

1:02:54

you seem to experience them, in

1:02:57

a cyclical manner, or because it is that

1:03:00

you're getting to the end of your period,

1:03:02

I guess, well, maybe not even that close,

1:03:04

but within the next however many years, it's

1:03:07

more a kind of all the time

1:03:09

symptom. It can vary. So some people

1:03:11

would say, some people it

1:03:14

might be that their normal menstrual cycle,

1:03:16

the feelings become amplified with the hormonal

1:03:18

shifts. But for some people, they'll just

1:03:20

go pre-air, I'm feeling more anxious than

1:03:23

I normally would, brain fog,

1:03:25

concentration issues, maybe stuff like hot

1:03:27

slushers, but people always, yeah, every

1:03:29

menopause, hot slushers, it's not just

1:03:32

that. It can be

1:03:34

libido shifts, it can be vaginal dryness, it can

1:03:36

be lots of different things.

1:03:38

And for some people, I guess, to

1:03:40

answer your question, it can be much

1:03:42

more persistent. It just feels really unfair.

1:03:44

That it's like you go through these

1:03:46

reproductive years. And

1:03:49

I mean, I guess there's plenty of families

1:03:52

having babies when they're

1:03:54

40. So I guess they could have only a five-year-old

1:03:56

when they go through menopause. But if I'm thinking about

1:03:58

my situation, then I'm like, Okay, when

1:04:00

I'm 45, my kids are going to be

1:04:03

at that age where I'm going to be

1:04:05

like, oh, I've got a little bit of

1:04:07

freedom. I've probably got a bit more time

1:04:09

to be having sex. And then it's like,

1:04:12

nah, nah, nah, nah. Here's some perimenophores. Here's

1:04:14

some amplified mood issues, some low libido and

1:04:16

some hot flashes. Like it just feels never

1:04:19

ending. That's where I say, and I agree with

1:04:21

you, there's a crap load to put up with,

1:04:23

but that's where I say we need to lower

1:04:25

the bar of, well, we're not

1:04:27

going to accept that as normal. Yeah.

1:04:29

Yeah. Yeah. Yeah. Some of us might

1:04:32

have no perimenopausal or menopausal symptoms. Some

1:04:35

people listening might have no premenstrual

1:04:37

symptoms and go PMS, PMD, that's

1:04:39

not me. Amazing. Some

1:04:41

people might have mild and manage it, but for

1:04:43

people who go, actually, this is

1:04:45

impacting my quality of life, my enjoyment day

1:04:48

to day, my ability to parent or have

1:04:50

sex or engage and be present in the

1:04:52

moment, you can do

1:04:55

something. I think that should be the way

1:04:57

for people. You've got options. They're not just

1:04:59

hormonal. Go and chat to someone. And

1:05:01

perimenopores as well is the time when as

1:05:03

a GP, it triggers me to go. This

1:05:06

is a reminder for me to really up

1:05:08

the preventative health stuff because heart disease risk,

1:05:11

stroke risk, bowel cancer risk, those things

1:05:13

are starting to climb. And so actually

1:05:15

when I see anyone who's perimenopausal, it's

1:05:17

a reminder to me to go, okay,

1:05:19

we need to do the blood pressure

1:05:21

check, the lipids, the cholesterol, the fasting

1:05:23

sugar. I need to put their little

1:05:25

stuff into a calculator, find out their

1:05:28

heart disease risk, have we done bowel

1:05:30

cancer screening, mammograms, cervical cancer screening. It's

1:05:32

actually a trigger for me to think of much

1:05:35

broader stuff. Can you move to Byron Bay? Yeah.

1:05:37

Do you know what else I think though? I

1:05:39

feel like growing up, you're like, oh yeah, menopause,

1:05:41

that's for old people. And now all of a

1:05:43

sudden I'm like in this stage where I'm like,

1:05:45

we're nearly there. I'm nearly there. The door, I

1:05:48

feel like I still don't really

1:05:50

know how to adult. I

1:05:52

don't fully understand what GSD

1:05:55

is. And she's barely parenting. And I'm

1:05:57

going to be perimenopausal soon. Yeah. I

1:06:00

just feel like I'm like, this is meant to be

1:06:02

an on-person issue. Well,

1:06:05

who knows who will go through it first, even

1:06:07

though you're a couple of years older, but I'm

1:06:09

just like, it just feels like, how did we

1:06:12

get here? I know. I know. But

1:06:14

I think, to give you some thoughts, and I feel

1:06:16

like that too, like I'm 37 and I'm like, shiver

1:06:18

me timbers in 30 days, I'm going to be 40.

1:06:21

And things are going to, you know, I'm going to

1:06:23

be thinking about, I just saw my JP and he

1:06:25

said, you know, should we think about a heart disease

1:06:27

health check? And I was like, fucking

1:06:29

hell. You're like,

1:06:31

now you should, because you've just nearly given me

1:06:33

a heart attack. You know, we

1:06:36

are aging and I think sometimes you still

1:06:38

feel like I agree with you. You're like,

1:06:40

I'm barely adulting and I'm about to go

1:06:42

through perimenopause, but at least now we're talking

1:06:44

about it. Like you're talking about it. Well

1:06:46

said. Media is talking about it. So at

1:06:49

least we're living through an age where we're

1:06:51

not behind closed doors going shivers. Is there

1:06:53

something wrong with me? Am I normal? We're

1:06:56

talking about it. So that's the kind of privilege of the

1:06:58

time we live in, I guess. Totally. And

1:07:00

I guess, as I said, it feels unfair. And

1:07:02

sometimes I look at my husband just like making

1:07:05

his way through the month with no fluctuations. And

1:07:07

you know, you could just, I'm

1:07:09

not going to say stab them because I've already said stab

1:07:11

once before someone might come over to my house. I don't

1:07:13

actually want to stab him. But then I

1:07:16

guess as you say, it's like, that is the

1:07:18

way it is. And we can do something about

1:07:20

it rather than just being like, this is unfair.

1:07:22

And I feel shit. Well, it is unfair. But

1:07:24

the fact is like, we can't change the way

1:07:27

that we've been made because we're all legends.

1:07:30

Really. Let's

1:07:32

all just realise that women are

1:07:34

the ones carrying the children because

1:07:37

we are stronger. And there is

1:07:39

such thing as man flu. That's

1:07:41

all I want to say. They

1:07:43

just have a life threshold. Yeah,

1:07:45

exactly. My point. I feel like

1:07:47

we've covered most of the stuff

1:07:49

in this topic. I have learnt

1:07:51

so much. This has been an

1:07:53

absolute joy and super empowering, which

1:07:55

is so cool. I'm glad

1:07:57

I made that doctor's appointment. Me too. reminded

1:08:00

some other people listening that, you know,

1:08:02

it's important to put your health, whether

1:08:04

that be mental, physical first. And

1:08:07

yeah, thank you so much for your time today.

1:08:09

Thank you, Bo. This has been an awesome chat.

1:08:11

I hope people really leave with some practical nuggets

1:08:14

that you can do stuff about your symptoms.

1:08:17

Nuggets. I'll

1:08:21

never go up. Let's go get some nuggets.

1:08:23

Thank you so much. Thank you. Thanks for

1:08:25

listening to this episode of Beyond the Bump.

1:08:27

If you enjoyed it, please subscribe and give

1:08:29

us a review. If you didn't, good

1:08:32

on ya. You can also follow

1:08:34

us on Instagram at beyondthebump.podcast to

1:08:37

stay up to date on behind

1:08:39

the scenes and future episodes. We'll

1:08:41

see you next week. Bye-bye.

1:08:57

Bye.