Professor Jayashri Kulkarni commenced her appointment as Professor of Psychiatry, The Alfred and Monash University in 2002.
She founded and directs the Monash Alfred Psychiatry Research Centre (MAPrc): a large group - dedicated to discovering new treatments, new understanding and new services for people with a range of mental illnesses. Jayashri Kulkarni graduated in Medicine from Monash University in 1981 and became a Fellow of the College of Psychiatrists in 1989.
She has conducted ground-breaking clinical research since then and is internationally acknowledged as a leader in the field of Women’s Mental Health, in particular for her innovative work on reproductive hormones and mental illness.
In 2021, in addition to her ongoing academic role, she founded and directs Australia's first Women's Mental Health Hospital.
In this session, Professor Jayashri Kulkarni discusses the mood swings and irritability that come along with perimenopause.
Here's what we took from her session.
It can be hard to know whether fluctuating moods are situational or hormonal.
Perimenopause usually comes at a time in women's lives when there's already a lot going on. Maybe you have ageing parents, or moody teens who are going through puberty themselves.
And a lot of women seem to describe an onset rage.
"In a nutshell, what I think is going on is, with the change and declining estrogen levels in the brain, in particular, it's almost as if there is a kind of uncovering of things that have been kept covered or submerged for some time. And that can be good and bad," Professor Jayashri says.
"I mean, there can be a sort of peace and calm that the person feels, but on the other hand, it could be a repression of things that were bad in the past and now have come up to the surface.
"I haven't found a completely illogical, no basis to the rage... Often it comes from things that have happened that have been very traumatic in the past. And it's as if the filter of estrogen in the brain has been removed, and so now you've got this expression going on."
Of women surveyed, it was common for people to report feeling enraged, as well as dull, flat and joyless during perimenopause.
But Professor Jayashri Kulkarni says you shouldn't just grin and bear it.
"Menopause is a 10 to 15-year transition process," she says.
"Now that doesn't mean that people are going to feel dreadful for all of it, but it's a very long time to just wish and hope that it's all going to go away.
"In particular, if women are experiencing all kinds of depressive symptoms, even if it is situational, they really need to get help.
"And I mean, of course, when I say help, I'm including biological treatments, with hormone therapies, or other psychological support, with psychotherapies, plus environmental or social supports, which is all sorts of things, such as help in the workplace or marital counseling.
"Many women experience a profound depression at this time of their life, and that's really not fair."
So, if you suspect you're going through perimenopausal mood swings, Professor Jayashri suggests first seeing an experienced GP.
"We need to have the discussion. Because we also need to educate primary healthcare physicians like GPs and other physicians about it all.
"Unfortunately, far too many women get told, 'Don't worry about it. It'll go away. It'll pass.' Or, 'Here's an antidepressant.' Without really unstanding that this is a hormone shift that is occurring in the brain that is creating massive turbulence in the neurochemistry, brain chemistry, and therefore resulting in a new depression that this woman has never had before. Or that she's had depression in the past. It's been satisfactorily contained for her.
"And all of a sudden all hell is broken loose and it's erupted again... It commonly gets misdiagnosed."
With an experienced GP, Professor Jayashri says you should seek out, and get adequate treatment for hormone-related mood swings.
Information discussed in The Very Peri Summit is for education purposes only and is not intended to provide professional medical advice. Readers should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional.
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