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Perimenopause starts earlier than you think- with Em Rusciano

02 Jun 2026

Transcription

Transcript generated automatically by AI and may contain errors.

Chapter 1: What are the early symptoms of perimenopause?

3.524 - 12.054 Em Rusciano

But the perimenopause thing is debilitating, real and the most brutal thing I've ever gone through and I felt so alone.

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12.958 - 13.399 Unknown

One, two, three, four.

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19.876 - 30.868 Steph Claire Smith

Em, I mean, we literally just started catching up and I'm like, this might as well be on record. It's been a while and I'm so excited to have you back. So first of all, thank you for your time because I know how busy you are right now.

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31.009 - 51.775 Em Rusciano

I know how busy you are, girl. Thank you for your time. I'm so happy to be here in your amazing set. Thanks. My back being worn on some kind of mohair soft. It's a sensory dream. She's been diagnosed ADHD and she knows what she wants and she's not afraid to put it on her set. I live for you. You've even got a little soft little cardi on. Yeah, thanks. I love it.

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52.096 - 68.366 Steph Claire Smith

I'm really excited. Obviously, we have had you on before to talk about things like ADHD, autism, and if anyone hasn't listened to either of those episodes, either from the miniseries... Or from the episode where you pretty much diagnosed me on the spot. We'll pop them in the show notes.

Chapter 2: How does perimenopause relate to ADHD and autism?

68.606 - 91.092 Steph Claire Smith

And we're definitely going to touch on that today. But a big topic today is also perimenopause, which offline you and I have connected about a few times. And thank you so much for being so open to come and talk about it. I think something for Laura and I when it comes to these kind of things that we go through as women, we've always felt like going into topics like this

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91.072 - 109.199 Steph Claire Smith

really helpful when either of us could relate, right? It's kind of like when we started talking about motherhood and like that started when I became pregnant because I could really relate to that element of the community. But we know that there's community members that are going through perimenopause and we weren't going to not talk about it just because neither of us have experienced it yet.

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109.78 - 133.067 Steph Claire Smith

And I really appreciate how transparent and honest you are about stuff like this and also love chatting to you and having you on. So... I'm honoured to have you here today and, yeah, really can't thank you enough to share your story and, you know, things that you've learnt and everything. But it might be kind of brand new information to some of our listeners. I mean, it was to me. Yeah.

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133.187 - 139.581 Steph Claire Smith

And I was in it. I would love maybe to start with... Did you, how do we start this? I've never heard of it.

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139.601 - 155.237 Em Rusciano

Yeah, okay. No, so I was, I went in, you know, and now I know my ADHD symptoms became so unbearable because I was in perimenopause, which is why so many women are getting late diagnosed because their estrogen levels are dropping. That's a brain protectant hormone.

Chapter 3: What lifestyle changes did the guest make during perimenopause?

155.317 - 178.858 Em Rusciano

Your ability to juggle multiple tasks is diminished even more. The brain fog increases, your ability to sleep, like it decreases. So all of the things you might have been masking well enough just absolutely go to shit. So for me, I was having all these strange kind of symptoms. And the hard part about perimenopause is there isn't like one test. There isn't one kind of catch-all.

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178.838 - 196.804 Em Rusciano

It's like I've got a frozen shoulder. I'm depressed. I'm anxious. I've got dry eyes. I've got itchy inner ear. I can't sleep. I'm anxious. Like it's just easy to like detach a lot of those symptoms from each other. And also maybe my iron's low. Maybe it's just, you know, maybe I'm exhausted. Maybe everyone around me is an absolute asshole.

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197.104 - 209.523 Em Rusciano

And I'm here today to tell you it's all of those things and perimenopause. And that was the thing. I went in and I said to Jamie, my doctor, and I'm just lucky also, and women's health should not be potluck.

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Chapter 4: How can quitting alcohol affect perimenopause symptoms?

209.543 - 229.534 Em Rusciano

You should not be just lucky if your GP is up on the latest stuff for women. And it is, though. It's still potluck because a lot of GPs, if you walk in in your 30s and say, I think I'm perimenopausal, they're going to send you away, possibly with an antidepressant, probably telling you to lose weight. And that is just, it is costing, literally costing women their lives.

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229.514 - 248.377 Em Rusciano

Because the suicide rates of women my age are, it's one of the fastest climbing cohorts. And the mass exodus of highly skilled, highly trained women from corporate jobs, they just fall off a cliff. Because this is a huge thing that's happening to half the population, yet there is very few studies done on it.

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248.857 - 266.703 Em Rusciano

The drugs available, the hormone patches are horrible, they're scratchy and itchy and they fall off in the shower. There's just not a lot around women. For half the population going through this thing, that starts in your 30s for a lot of us. And the thing with it is whenever anyone mentions menopause or premenopause, there's a lot of like, oh, that's old lady. It's an old lady thing.

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266.723 - 278.1 Em Rusciano

That's when you're a witch with a beard. You know, and on one final day, your vagina gives an exhausted cough and you have your last period. Oh, I'm in menopause. Like, that's what we all thought it was.

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278.12 - 278.861 Steph Claire Smith

No, it's true.

279.001 - 289.374 Em Rusciano

It's true. If someone had said to me at your age the word perimenopause or menopause, I would have been like, get away from me with your ageing stick. I'm young and vital and supple and amazing and moist.

Chapter 5: What role does strength training play in managing perimenopause?

290.155 - 311.111 Em Rusciano

Ew. But now I've found out I was 100% in perimenopause in my mid-30s. I've gone through it earlier, which does happen to neurodivergent women, anecdotally, no studies, shock horror. But yeah, you go in and I said to Jamie, I'm just, I've had the ADHD diagnosis, but I still don't know what's wrong. I'm really struggling.

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311.613 - 311.935

And I was angry.

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312.59 - 331.749 Em Rusciano

So when you went into the doctors, did you say, I think I have perimenopause or did you just say what's wrong? Yes. Yeah. Okay. He brought it up. Yeah. And I said, what is this perimenopause? Because to me also, it feels like it's a way to soften menopause. It's like menopause is sexy younger sister. Like I hear seven year old women saying they're in perimenopause in the entertainment industry.

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331.789 - 342.865 Em Rusciano

Because if you say the word menopause in the entertainment industry, watch all your jobs disappear. And I've noticed a few women that I follow who are senior citizens saying, oh, I'm in perimenopause? And I'm like, girl, those ovaries.

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Chapter 6: How does perimenopause impact mental health and relationships?

342.885 - 355.096 Em Rusciano

Yeah, yeah. I did egg on. Yeah. It's almost the more acceptable version of menopause. Yeah, right. But it is definitely a thing that happens up to 10 years before the last cough, as I've come to call it.

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355.216 - 357.241 Unknown

I get such a visual of that.

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357.301 - 365.9 Steph Claire Smith

It is that. It's like that drawing, that like rage kind of ovaries drawing that you have. I just literally imagined that coughing. Yeah, it's what she does.

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366.341 - 391.151 Em Rusciano

But nobody tells you this. No one warns you. No one in high school health... all of women's health is centered around our reproductive health, our ability to have babies. And I did a podcast called Rage Against the Vagina. I had 25 experts in there and some of them who are top of their field did one afternoon on perimenopause, menopause training in their entire six-year degree.

391.171 - 393.255 Em Rusciano

The rest of it was around babies. Yeah.

Chapter 7: What are the common misconceptions about menopause?

393.235 - 405.466 Em Rusciano

because that's all we're useful for still. Yeah, I know. But the perimenopause thing is debilitating, real and the most brutal thing I've ever gone through and I felt so alone and the magnitude of symptoms like dry eyes.

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406.267 - 423.242 Em Rusciano

I thought I was going blind and I went to see my optometrist and she said, you have clinically dry eyes and because testosterone actually is part of the oil production in the glands in your eyes. Right. Because women also need testosterone, Steph, and that drops. Mine went down to you couldn't measure it in the tests.

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423.222 - 438.921 Em Rusciano

And the blood test that they'll say to you, oh, they're not reliable because hormones go up and down. Yes. So that's why you have them regularly. And you work with an endocrinologist. I had to because of how young I was. But the lack of information out there is breathtaking. And what is out there is overwhelming.

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439.282 - 450.981 Steph Claire Smith

Yeah. Yeah. So when you heard... That's the longest answer anyone's ever given you in your life. I mean, that's the point of the podcast. Please give me long answers. When you heard perimenopause and obviously you were like, oh, what is that?

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Chapter 8: What advice does the guest give to women experiencing perimenopause?

451.001 - 459.034 Steph Claire Smith

When you started to talk to friends about it, was there anyone that you knew that had gone through it and just hadn't brought it up? Yes. Really? Yeah. Yeah.

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459.014 - 483.197 Em Rusciano

Shame. Total shame. Didn't want to be associated with that phase of life because we are not allowed to age. We genuinely congratulate women who look impossible. Like J-Lo at Coachella in a leotard cutting straight up her labias, like 56 years old. And everyone's like, wow, that's so amazing. Look at her. She's not aging. We want women to look 16. And if they don't, they've somehow failed.

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483.357 - 504.398 Em Rusciano

So the idea of talking about the literal aging of your reproductive is terrible. Yeah. But also we do put it down to it's our fault. We're not... Which is so... Yeah. Women will blame themselves before they will think that perhaps it's a biological issue that is well beyond their control. We're not exercising enough. We'll pathologize ourselves. We need to change our diet.

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504.418 - 523.277 Em Rusciano

We need to get more sleep. We need to buy this thing. We need to spend more time meditating. We need to, you know, be better mums, better bosses, better parents, all the things, better friends. And it's so exhausting. And then all of a sudden, the hormone that helps you achieve all that starts exiting your body at an alarming rate.

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523.357 - 523.497 Unknown

Mm-hmm.

524.506 - 528.617 Em Rusciano

That estrogen? Yeah. And it falls off a fucking cliff.

528.718 - 538.545 Steph Claire Smith

And what happens, like, so obviously perimenopause, menopause, it can go over a matter of years. Yeah. When it's over, do we, like, get a break?

539.046 - 539.106

No.

539.407 - 549.403 Em Rusciano

No, I mean, no. Then you go through all the... No, it never ends until you die. Because if you think about cave lady days, we weren't meant to live past having babies.

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