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Episode 259:
Show Notes Â
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In this week’s episode, Dr Lucy Burns is joined by Associate Professor Erin Morton, a leading health and medical researcher and founder of the VITAL Perimenopause Registry, for a powerful discussion on the lived experience of menopause and why better research, education, and support are urgently needed.
About Our Guest
Erin has over 20 years of experience in clinical trials and academic medicine. She holds a PhD in pharmacology and international accreditation as a Clinical Research Associate. Having contributed to national and international clinical guidelines across multiple disciplines, Erin now focuses on improving women’s health outcomes. She recently launched the world-first VITAL Perimenopause Registry and a research consultancy aimed at transforming women’s health through better strategy, collaboration, and real-world insights.
Key Topics Covered
- The VITAL Perimenopause Registry
A first-of-its-kind, community-led registry that collects real-world data from people across Australia—patients, partners, clinicians, and policymakers—capturing a wide range of symptoms, impacts, and priorities. - Why This Research Matters
The registry’s goal is to amplify the patient voice, guide research priorities, inform clinical practice, and influence policy—including often-overlooked areas like mental health and workplace impacts. - Education Gaps in Menopause Care
Erin and Dr Lucy discuss how medical education often overlooks menopause, leaving many clinicians unprepared. Erin is currently running a study to upskill rural and regional doctors via telehealth support. - The Role of Telehealth
Telehealth has made menopause care more accessible, especially in rural and remote areas, though individual preferences for care delivery vary. - Mental Health & Work
Erin highlights the significant but under-recognised impact menopause has on mental health and workplace performance—something her research is bringing to the forefront. - Menopausal Hormone Therapy (MHT)
The episode dispels common myths about MHT, particularly around breast cancer risk, and emphasises the need for nuanced, evidence-based conversations. - A Call for Community Involvement
Listeners are invited to join the VITAL Registry and help shape the future of menopause care by sharing their lived experience—anonymously and securely.
Episode Takeaway
Better support, education, and research for menopause are long overdue. The VITAL Registry is helping to bridge that gap—one story at a time. Empowerment, evidence, and choice are at the heart of this vital conversation.
Connect with Associate Professor Erin Morton
đź”— LinkedIn
📸 Instagram: @aproferinmorton
🧵 Threads: @aproferinmorton
👉 Join the VITAL Perimenopause Registry
Episode 259:Â
Transcript
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Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:12) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:21)Â Â Good morning my lovely friend, how are you today? It is a glorious day where I'm recording and this week I don't have Dr. Mary, but I have got a special guest and you know that we love bringing you experts in the field. So I am super excited to have a chat with my friend Associate Professor Erin Morton. I know, professor, she's smart. She is the founder and director of Bespoke Clinical Research. Again, an area, research. I am not a guru at all in research. So it's always great to talk to experts in that field. So Erin, welcome to The Real Life Medicine Podcast.
A/Prof. Erin Morten (01:02)Â Good morning, Lucy. Thank you so much for having me.
Dr Lucy Burns (01:04) Oh, you are welcome. You are welcome. So, we met last year at the International Menopause Symposium. Menopause is one of your, you know, topics that you are an expert in. So, tell us a little bit about why you're interested in menopause.
A/Prof. Erin Morten (01:22) Well, I'm a researcher of 20 years, and all of that time's been spent in health and medical research. So, usually running clinical trials and health data registries, which, effectively, all of those things are looking at either what the status is of people's health and quality of life, and/or if we introduce new things, can we make it better. So, sometimes that might be a new medicine or device, but other times it might be about changing the patient flow through a hospital or how they and when they see their doctors. So, it can be quite a broad range. I work in multi-discipline areas. I'm really interested in basically everything, which isn't always typical of a researcher. Often we have our particular niches, but for me, I, like so many people in the menopause space, was hit by peri at 43, and even with my knowledge, with my access to publications behind all the firewalls, I was currently running up to—I think it was close to—40 different projects with our clinical director of the Women's Local Health Network where I live in Adelaide, and I still couldn't get any information that was relevant to me. But I was extremely fortunate that my symptoms seemed to be cyclic, so that clued me in. My GPs were brilliant. I went in and said, hey, can you help? And they understood, took me seriously, and it was a little bit of tweaking along the way, but I got myself sorted relatively quickly. However, I realised that I was very lucky, and that using my research expertise, I could hopefully make it easier for everybody else as well.
Dr Lucy Burns (03:07) Ah, absolutely. And you sound like you've had almost, you know, the dream run, and that is not the case for many other women.Â
A/Prof. Erin Morten (03:14) No, no. And even having said that, like so many, it wasn't fun at the time. There was no way on earth I could have kept my job if it had been a very traditional one. At that point, like now, I control my hours, I control where I work, I control what I do. So as long as I could keep sort of hitting my measurables, it didn't matter if, yes, sometimes I'd sleep till midday, other times I'd wake up early and have a nap in the middle of the day. Other days, you'd know the executive dysfunction was just not going to work with me, so that would be an admin day. But yeah, I was very fortunate that I was able to work out those different things and part of my research background was in pharmacology. So in starting on MHT, which for me was the deal winner in terms of, I was going to say deal breaker, but deal winner. It allowed me to get back into my exercise to bring my life back together, but also I had a pretty realistic understanding of how long it would take on each dose or each formulation for things to really kick in to test things out. So certainly all of that helped, but I realised that unfortunately, traditionally in medicine, as you'd be aware, there's not that much emphasis on women's health and even more broadly, it's been a lot of clinicians and researchers going, oh, I see a gap, I think we should study this, as opposed to reaching out to all the patients and going, what matters most to you? So effectively, that's where I kicked off my research, my big involvement in the menopause space by setting up the Vital Perimenopause Registry. But effectively, it's a world-first, community-run registry. So a registry is effectively an ongoing survey. So it means that whether it's today, whether it was last year after we launched, or whether it's in five years time, people can hop on, they can indicate if they are in perimenopause or they think they might be, or they might be a workplace colleague or a policymaker or a friend, basically anyone over the age of 18. We want to know where you get your information from, how much you think you might know, and you know, that's perfectly fine if it's not very much at all. I certainly didn't before I hit this stage, but then also it's about, okay, so we might have certain symptoms. Sometimes, very often, I certainly thought, I was one of the, not just thousands, I think millions, that thought symptoms would be hot flushes in my 50s after my period stopped, none of which were true. So it is about the, oh, there are these other things. It's not saying that perimenopause is responsible for everything, but it's about raising that awareness, looking at what different things work for different people and what sort of impacts people had. For example, night sweats could have been my worst symptom, but I might think that the mental health issues are the biggest concern from a community point of view. So we're not just looking at what is the most common symptoms, but also what is at a community level, where do they think we should be focusing our interests? Because let's face it, there's hundreds of thousands of questions we could be asking because we've got a lot of things to catch up on.
Dr Lucy Burns (06:36) Yeah, absolutely. And I think it's so interesting to me, the whole menopause, perimenopause discussion. And it's so, I feel so embarrassed because as a female doctor in my 50s, I knew nothing. I sort of thought, oh, well, you know, you just finish your periods. Yeah, you get some hot flushes, some hot sweats, and that's about it. And, you know, just mosey on through and, you know, we might use a couple of medications and, you know, and that's about it. And even more embarrassing was that I had my own menopause symptoms. I didn't even recognise them. I didn't realise that these were menopause. And again, I have to be kind to myself because part of my brain goes, what sort of doctor are you? You didn't even know your own self. And then I think, well, you know, there has been a failing in the medical education.
A/Prof. Erin Morten (07:24) Well, that's certainly what came out of the Senate inquiry, isn't it? The clinicians aren't prepared because they're not educated on it.
Dr Lucy Burns (07:31) No, I know. And so it's really hard at the moment because there are still plenty of doctors who don't have education on it. And it's really, I think general practice is tricky because, you know, a GP is supposed to know everything about everything. And so, you know, are they spending their time getting updated on asthma education? Because, you know, in Melbourne, asthma is huge. Is it eczema, allergies, anaphylaxis, menopause, arthritis, autoimmune conditions, thyroid? Like there's so many things that you need to be continually upskilling on. And I feel like we need to be a little kind at some times when the doctors don't know. But by the same token, doctors also need to be open to the fact that not to dismiss women, I think it feels.
A/Prof. Erin Morten (08:19) Yes, 100 percent. Amongst the various projects that I've got going on, obviously Vital's one of my babies that's been running for about a year. We have well over seventeen hundred participants from literally across the country, over seven hundred thousand data points and over six thousand comments on lived experience, because that's the whole point. I know what I want to ask, but I don't know what the experience is of someone else. But that led me to thinking particularly about what clinicians were saying when I was asking them about what training they'd had or how comfortable they felt, what we saw from the Senate inquiry. And recently I've launched a new study and the research wheels do take a long time to happen. So this has been in the works since last September. But we are officially recruiting clinicians in rural and regional areas to try to help them upskill on menopause. So it's not about introducing some new flashbang thing. It's about trying to make it as easy as possible, as you said, for GPs who have thousands of different calls on their time to try to make that easier for them and therefore make it easier for the patients. One of the things I've been, I guess, upskilling myself on recently is digital health in the rural regional areas, because certainly there's so much more that we can do now, obviously here in the metropolitan areas. But also, yeah, whatever we can do to make things smarter and make things easier, both for the clinicians and the patients.
Dr Lucy Burns (09:50) Oh, absolutely. And I think I mean, I guess, you know, from my point of view, one of the best things that came out of COVID is, you know, people's access and use and familiarity with things like telehealth and the fact that that now can actually, you know, it can work in with traditional general practice and that, you know, traditional general practice needs to evolve somewhat, because I think one of the barriers is people are busy, you know, you don't want to go, you've got to leave your job, you've got to organise someone to look after kids or pick up somebody or whatever, go there, you sit there, quite often the times aren't allocated. And that's a whole other thing. And it can take half an afternoon to just talk to somebody about something that might really take 15 minutes or half an hour. Whereas with telehealth, you don't have to factor in any travel. You can, you know, if you're waiting, if they're late, you can do something else. It's like it's revolutionising. But I guess from my point of view, I get there's concerns because I also see what I like to call the tech bros who are coming in, trying to streamline the process, which again is great, but they do it possibly at the expense of quality care.
A/Prof. Erin Morten (11:10) And that's the thing, I think we're all limited by what we see. So someone who only sees people in person may perhaps have a not completely representative understanding of how many people want to see their doctors in person versus telehealth. For myself, I would prefer my first appointment to be in person to have that relationship. But then I'm very happy and I would prefer telehealth after that, because even though I'm quite close to my clinicians, as you say, just the time factor makes a big difference. And that's also one of the other questions in Vital, because we need to recognise that people's circumstances are different. And there's such a broad spectrum when you look at Australia's population, we don't have to have one answer. We shouldn't be looking for one answer.
Dr Lucy Burns (12:03) No, absolutely. And I think you're right. I mean, and as you said, if you're rural, it might be an hour drive to your local doctor or you might not even have a local doctor in your town and you've got to drive three hours or you might not have. And again, we look at things like accessibility to transport, maybe you don't drive. And, you know, doctor surgeries are not often on public transport routes or maybe you've got chronic conditions or you're like me, you have a disability, getting somewhere with a disability is just another layer. It's not impossible, of course, but it's another layer.
A/Prof. Erin Morten (12:37) Yep. And certainly it's interesting from a research perspective. So amongst my various disciplines I've worked in previously, I spent 10 years in the cardiac space. Most research projects that I've done have been national ones. And with Eastern Seaboard obviously having our biggest population, so many times I've been speaking to cardiologists or clinicians and, you know, setting up training meetings or whatever. And they'd be like, oh, just pop down the road for a coffee. And I'm like, I'm in Adelaide and this is pre-COVID. So, you know, that sort of understanding of what actually we can being very attached, tethered maybe to the laptop, but it means that I can do it anywhere. And one of the presentations that I was fortunate to do at the World Congress last year was about knowledge translation. So effectively, is all this expert knowledge actually getting out there into the community, into local GP practices? And unfortunately, the answer was mostly no. Certainly the clinicians got the best scores of anybody, but it was also often people in Perimeno saying they had no clue before they started this journey. So, you know, that sort of directs us, OK, well, that's something that we need to look at. Certainly the mental health and the workplace impact were two other very big things. As you said, being taken seriously, there was certainly, as I said before, executive dysfunction, but also mental health were two of my biggest issues, which I'd not had any issues with previously. But again, some of that understanding was I was fortunate that I was prescribed MHT straight away and I did that on an antidepressant at the same time. But for me, I needed it. And once I was able to get my life sorted out, I was able to go off it. Now, that's not going to be the case for everybody. I'm not saying, you know, rush to get off it. But at the same time, again, from a research point of view, I looked at, OK, well, these are my short term symptoms, but also what sort of long term impact is my lack of hormones going to have? So I knew about the osteo, I think most people do, but it was only because of some other projects that I've done that I realised not so much the impact of having osteo, but the consequences of once you have those first fractures. And I had no clue how impactful that could be on your life. And so suddenly when I was able to put those two together purely because of that previous experience, I went, oh, OK, and then looking at my family history, I know there's various things in the cardiac space. So that's something that's a particular concern to me, looking at the high cholesterol, high blood pressure and all these other things. And I will say I'm someone I don't take a pan at all unless I've made sure I've had enough water, have I had something to eat, have I had some fresh air. But at the same time, I realised that I want to live not just a long life, but a high quality life. So for me, if MHT is maintaining my hormones and maintaining my health, then I'd vastly prefer one medication being the MHT versus being on a polypill. And it's not to say that eventually I won't need that, as we may all do as we age. But with that as my sort of my foundation, I've started running again, which I've always loved. But certainly the last few years, no way on earth was that going to be a possible thing because I just couldn't get myself out there. But sometimes having those different areas certainly have helped. And I think that's one thing that I'm wanting to come out of Vital and my other pieces of research as well, is that I think if you're having mental health symptoms, short term, obviously do anything at all that is necessary. But at the same time, trying MHT is not addictive. We can try it for a few months, see if that helps align everything else. And then it's up to the individual. And as I said, obviously, I'm a big fan. But at the same time, I do want to change the social media sort of messaging that unfortunately is still very much caught up in the WHI study, I will say, and I have permission. My mum's had breast cancer twice. So I've started on this with full awareness of that, obviously directly in terms of perimenopause, even though she was diagnosed after I actually, in terms of age, started my own symptoms, it meant that our two experiences were actually different because her menopause was brought on by the chemo and radiation, etc. But it also meant that while, as I said, I was extremely fortunate, I went to my GP, I was able to get things sorted straight away. The number of people that I mentioned, you know, oh, oh, but you know, MHT or HRT, as it used to be known, causes breast cancer. And I'm like, hmm. And it's still so prevalent. And as a researcher, I have to say, it really, really annoys me because so much about research is going, OK, we take step A and then we build on that to go to step B and we work out what the limitations were and we fill the gaps or we work out whether that was a genuine answer, because it all depends on the design and the different ways you do things. And in the case of the WHI, obviously, it was gigantic in terms of the number of participants, which is phenomenal. And honestly, full kudos to them for doing this. But the media reported it wrong in the first place. And then the researchers themselves redacted the papers. And that's rare. Like that really does not happen very often unless there's some big problems in it. And then also you obviously have the fact that what was used then is significantly different to what's used now. But effectively, one of the things in research, which can be both problematic and wonderful when you're actually running a study, is that when you're planning how many patients or clinicians are involved in a study, you're planning that based off background information. So historically, how many people have certain symptoms or how many people work in this place or that? And what they found even with that was that the background rate in their study did not match the real world background rate. And that's where the difference perhaps arose, even if there was one there to start with. And when you're running a study, you can if you actually have a higher level of events or whatever it is that you're using as your end point, your goal marker, you can actually finish your study even quicker, which financially, time wise, getting answers, all of those things can be good, but that doesn't necessarily mean it's good for the patient. So on the one hand, genuinely, that's awesome that the non-HRT people within that study had less of a normal incidence of breast cancer. But unfortunately, that's meant for the last 20 years, we have this massive effect that is still out there today. But when you look at the facts, it is not what you thought it was. It may not be what your family members are saying. Sometimes your clinicians, unfortunately. I do love that the Senate inquiry recommended more menopause training for clinicians as they're going through medical school now. But also we want to try to help both the community and clinicians that are practicing now, rather than waiting for 30 or 40 years as these new ones work their way through the systems.
Dr Lucy Burns (20:28) Yeah, absolutely. And I think something that you alluded to, and I think this is hugely problematic, is that lots of people are getting their information from the media and the media's job is to sell stuff, sell articles, sell advertising and get clicks. And humans, humans love division. We love controversy. We love anything that sort of feels dramatic. I mean, that's why everyone watches maths and, you know, nobody's out there. You know, people aren't watching, you know, Gardening Australia because, you know, we love war. And so it's really the headlines. And I really wish that journalists were held a little bit more accountable to the information they're filtering and providing, because there's only a couple of journalists in Australia that I really respect. A lot of them, it's just clickbait.
A/Prof. Erin Morten (21:25) It's really unfortunate with the way things are. And I haven't had too much to do with journalists unless, obviously, you know, International Women's Day, International Menopause Day, those sort of things. And I have been extremely fortunate that what they've passed on from my comments has been, by and large, accurate. And obviously, no one's going to get everything correct when it's in a field that isn't theirs. But at the same time, again, one of the problems with menopause is because nothing's been done for so long and in research, women were only, not even only ever introduced, but it was a recommendation with the American National Institutes of Health in 1993 that meant women got included in clinical trials. And before then, they were excluded because, quite frankly, when you throw in hormone cycles and other potential comorbidities and other things that might be happening, it was cheaper and quicker to get medications onto the market. And I'm not saying that genuinely as a purely financial thing. Sometimes it's a matter of, well, if it's getting on the market sooner, then that's helping potentially millions of people across the world. But at the same time, you then have a number of things out there at the moment who have recognised there is this big gap. And if they put the name menopause on there, then some people, because they are so desperate, because there has been so little done, they're searching for anything that they can. I completely get that. But at the same time, that's where I just want people to have the right information, the evidence based information, and then they can make their own decision. I do think, unfortunately, referring to those wars, there has been a lot of stuff stirred up. And my background, as I said, 20 years in health research until last year, all of that was in academia and not for profit. So my state health department, health government department, not for profit medical research institutes and multiple universities. Within that, it's probably been about half and half of purely academic questions, but also questions that have something to do with industry. Now, that might be what's called a sponsored study where they say, hey, we want to test this thing out. And I'm really proud to say, and because it's a 20 year cycle, one medication I've worked on got onto the market and it's helped cardiac patients across the world. But then we also have the other side of things where there's different expectations. So, yes, I get every commercial company as such needs to earn their money back. That's understandable. That's what pays for people's mortgages. But at the same time, from an academic point of view, I also know in applying for my own promotion, in trying to set my team up in the right, appropriate roles, that academics also have KPIs that include your international reputation and how many times you get invited to conferences to speak and those sort of things. And I think some of that media war is unfortunately to the detriment of the patient. And I'm including myself in that because it's not about what background they are from, because I can guarantee you, particularly in menopause, a lot of people have left their jobs and are trying to do something and they are on far, far less than what I was on as an academic. But at the same time, there are in every field, whether it's commercial, whether it's academic, there are people that are in it for the right reasons and people that maybe not so much. So I do look on with some of that media stuff, just finding it very, very disappointing. And it's not to say that any area of medicine should bear it because the patient should always come first. But in a field like this where there is so much to catch up on and there are so many questions that haven't even been looked at, we really need everybody. We need everybody who's interested to get involved and to be encouraged to do so. And if you've got an idea to be able to reach out and say, hey, I don't know about this and this is what I do with the clinicians I work with a lot. I'm like, I think there might be a gap there. Is it of any relevance? And sometimes they'll say, yes, that's what we're seeing. That's not what we're hearing, but that's what we're seeing with our patients. You know, this is something we should look more into. Other times I'll be going, yeah, there is. But realistically, Erin, just forget about it because who cares? We don't care. Our patients don't care. It's a tiny little pebble amongst a mountain of other issues. And that's, I think, where there is so much to be done that it's important. We try to keep that in balance and not worry so much about where people are from or what their reputation is, but more about have they got a good idea? Could this improve outcomes for all of those with lived experience for our clinicians to make it easier for them? And, you know, and all the sort of downstream effects on that as well in terms of workplace impact, the financial impact. There's some people that do it very well. I'm hoping that as more happens in menopause, that there is more celebration of everybody who's doing something to try to make things different.
Dr Lucy Burns (27:03) Yeah, absolutely. And it's just worth knowing, I think, for humans. Humans are funny. We're funny creatures. We sometimes like binary decisions. Yes or no? We're not very good at it. It depends. Like most people, if somebody asks me a question, I start with it depends. I can see their eyes glasing over. And but honestly, it often does. You know, that's the whole point of expertise is nuance. And the answer is it often does depend. And so, you know, again, I've spent a lot of time in the nutrition space. If you want to go for a war, there's wars there all the time. There's people defending their turf. And, you know, Mary and I try and think of things like, you know, be open minded. I love this phrase. Be open minded, but not so open minded that your brain falls out. I like that. Yes. So you want to have sort of skepticism, but again, not so skeptical that everything is a conspiracy, because if you believe that everything is a conspiracy, you're going to miss stuff. And, you know, for us, medications, again, it's like they absolutely have a role. They honestly do. But there are people out there who think every single medication is just big pharma trying to control us. And I think that that comes sometimes from a place of health privilege. And I look and I think, you know, if there was a medication for muscular dystrophy, I would sure as hell be taking it. But there isn't. There's not enough research. It's not enough funding. Nobody's interested. It's boring. No one's talking about it. There are no wars on muscular dystrophy. If there were, I'd be happy. So when people kind of come in and again, it's a combination of mainstream media and also, you know, as we've talked about, influences in any space, whether it's menopause, whether it's nutrition, whether it's and again, you know, business, anything, people have these firm, fixed, loud opinions. And I just say to people, if you're hearing that it's a one a one solution, one trick pony, as I like to call them, then then they're likely to be wrong.
A/Prof. Erin Morten (29:08) And that's it. And I think, as you say, particularly, unfortunately not muscular dystrophy, but particularly in areas where there is a lot left to be done, like an incredible amount. And it is about that respect in that just because I couldn't find the answer that I needed, that doesn't mean I don't respect what has been done in the niches that help a lot of other people. And that's something certainly I found working in the cardiology space. As you might imagine, there are a lot of strong opinions there. And each clinician, each researcher thinks that their area is the most important, understandably. But they also truly respect that even if they don't agree, their colleagues, their collaborators, their competition's patients also think that those other areas are just as important for them. And yes, so many of us will eventually be affected by something to do with our cardiovascular system. I get that. But at the same time, the Australian Bureau of Stats: one in four Australians—so not just one in four females, but one in four Australians—are born with ovaries and are currently 40 or over, which means we're either in peri or approaching it. And again, we don't know yet. We can't predict. I would love—I've got all these things in about 10 years’ time where I'd love to do all this sort of prediction. I've got kids. I've got cousins and nieces and nephews that I'd love to think that this could be more of a known journey and bring it back to a bit like asthma. You think you have asthma. You can go to your doctor. You can go, I think I have asthma. They can not only confirm a diagnosis but maybe talk about what your particular triggers are, give you a range of potential, not just medications, but other things to do in combination that help you. And then once you're sorted—and it might take a few months to find just the right thing for you—but then you're all good. And because you might have one particular aspect of it, it doesn't devalue any other aspect in any way. But at the same time, we need to recognise that those other aspects do exist and we need that additional research. We need additional clinical care. We need additional education. And as you say as well, the influencers, the people that have bigger names for whatever reason—honestly, again, kudos to them—but as a patient, what I want to say is that there is that open-mindedness. And certainly when I look back at the Senate inquiry, the two biggest things were education for both the community and clinicians. But the second thing was we need more open-mindedness. We need to look at new ideas. We need to perhaps go beyond the boundaries of Australia or the boundaries of what has traditionally been done, because we are now recognising—and only recently—like the musculoskeletal syndrome of menopause. I mean, the fact that that's been defined in 2024. I mean, so, you know, it's all that sort of thing. And I would hope—and again, being, I don't know that I want to do the maths, but well over 90% of my career in academia—I know what the systems are. The track records are for your big government grants. I know where a lot of those sorts of things are judged on merit and on past histories. But I certainly hope that they—that the government, you know, whichever government that might be, given that all three of the biggest parties have amazingly and wonderfully announced these amounts of money that are going to go towards women's health—but I also hope that they don't just give it to the same people again, because while I truly respect what has been done in those existing areas, you know, we wouldn't be having this nation and international call for more if it weren't for all these other areas. And the best people to deal with those other areas are the people that are the experts in those other areas. And I think that's where I'm—genuinely, I think—the politically, or the parties getting on board with making those promises is absolutely phenomenal and certainly what we've been working on. I know going to the parliamentary breakfast on menopause, the first ever, hosted by Peter Murphy. But that was back in March 2023. And it's amazing to look at what's come out of that. But even back then—and that was before all the community lived experience calls to the Senate inquiry—that we needed more. We need more people involved because that's how we're going to get answers to the questions that are going to help everybody quicker. I really, really hope that we'll see that. We'll wait and see. I think that's an area that we may need to come back to.
Dr Lucy Burns (34:19) Yeah, absolutely. You know, I love what you're doing with Vital. And I will definitely put the link in the show notes. So lovelies, if you're driving, you don't need to worry. You can get the show notes at the end, because what we know is, you know, people will dismiss anecdotal evidence as not being evidence. And technically, it's not evidence. But we know that anecdotes—when you have enough of them—people go, oh, maybe that is a real thing. Like maybe that's not just somebody's one-off, nothing to do with it, you know, had they happened to have a bad day that day, when you have a lot of it. And so if we don't have a registry to collect these anecdotes, then how can we look into it?
A/Prof. Erin Morten (35:02) And that's it. And as I said, as a clinical trialist, you know, my job is to create the highest level evidence, and that is a randomied clinical trial. But also, as I said before, that is completely limited by who you can get in the door, and the telehealth—all those different things that we can do now—we can certainly do a lot more, but that still will never replicate the real world. And that's where the different questions, you know, evidence, yes, have different levels, but also needs to have those different levels because the people I will have in my clinical trial will not be the same people that I can reach with a registry. It was one of the questions in even designing it. So every other registry, every other sort of data questionnaire I've ever done in research has been maybe a tenth of the size that Vital is, because you can get concerned about people getting fatigued answering the questions, and then you may lose them, or they may not recommend it to someone else. You know, there's those sorts of considerations. But then when I reached out—and I did so for a good 18 months before I basically put pen to paper and actually started building the registry—the thing I kept getting told was there's bits. We get asked about hot flushes, or we get asked about our periods. We don't get asked about workplace impact, or we don't get asked about this or that. Or if we do, it's a heap of different other things.
Dr Lucy Burns (36:31) And so with the registry, you know, we've talked about it—being anecdotes are super helpful, especially when we now know, you know, lots of people have a certain symptom. Therefore, we need to investigate it. So anecdotes aren't actually research, but they're, I guess, an indication that we need more research on a certain aspect. So Vital will play a vital role in this. Yes.
A/Prof. Erin Morten (36:50) Yes. There's a reason we love our acronyms in science. So what it stands for, effectively, is a virtual, in terms of online, registry of perimenopause in Australia. And that's the point of it. So I designed Vital to include all of the different questions, but also to give people different options. So there are only two mandatory questions, one of which is whether you were born with ovaries, and if so, what stage of those different aspects you think you might be in. So anybody over the age of 18—if you're a partner or a workplace colleague, male included or female, if you're lucky enough not to have symptoms, yay for you, or premenopausal as well—like any of those things, we're still really interested. Not a single skerrick of data is saved until someone chooses to press save. So I genuinely think it's still a win if people go through the questions and go, oh, actually, that might be related to this. And it might not be, but it's about informing people. And we also have the option. It's effectively anonymous unless people choose to put information in there, because there is that aspect. If I had people coming into my clinic, then yes, I would be asking all sorts of questions. However, even though in science we're quite blunt about all sorts of biology, I found once I released Vital, I'd have people speaking to me literally in the corridor of the medical centre I worked in about their menopause and their perimenopause symptoms. But they'd be going, oh, I'm not sure whether I should include my information in Vital because I don't want people to access it. Particularly given that I'm asking about mental health, I'm asking about workplace impact. So, number one, if people don't want to put their details in, they don't have to. Number two, even though I'm not technically an academic anymore, there is no way I'd do anything without ethics approval. So this is still maintained under the highest level NHMRC—so National Health and Medical Research Council—accredited Human Research Ethics Committee. For anyone other than myself to use the data, it needs to go through a full steering committee, a full ethics approval process for that question. Beyond that, it's also a matter of what the question is. So only de-identified, aggregated, and grouped data is provided. So I was asked the question recently by a clinician as to whether I had any information on something. And so I was able to drill down amongst my 700,000 data points and say, look, I can say for the moment that it seems at a national level we're complying with clinical guidelines. And that's awesome. People were being given what they should. If they weren't, it's because of contraindications that they mentioned—that there were other issues going on. But it's very early data. So even though with that particular question, I had an answer. It was also, I'm not guaranteeing that this happens across the entire country because the number of people we have so far is very small. But also it was discussed in percentages. So there is no way there is any way to drill down on any of that. The other thing with Vital is I recognise that as a researcher, I have the option. I sometimes hear about things, you know, from colleagues or around the traps. And I can go, hey, I want to be involved in research in this aspect because, you know, I've got a condition myself or my parents or whatever it might be. Not everyone has that option. And again, when it comes to the media, I might be contacted. But someone else who wants to share their story may not be. So one of the things that we have in Vital is tick boxes where people can say, yes, I want to be contacted to share my story or I want my data to be used—not just for things that I might put together, like for the World Congress, where it said these are the percentages of Australians that have this symptom or that feel they didn't have knowledge beforehand but they're pretty good now, or that their highest community concern was whatever—all of that in percentages. But also it's a matter of, again, from not reinventing the wheel, not just for the researchers but so that we get to answers quicker. People can tick if they're happy for their information to be used for future ethically approved projects. So, you know, it's all at the absolute highest level. The data platform that I use has been approved by the digital health unit of one of our Australian state health departments. So—and it's actually on the state health department service. So we are talking about the highest level of security and confidentiality. Which different things are required for different purposes. But for Vital, I wanted the absolute highest level so that anyone putting their information in can choose what level they're comfortable with. But also we can encourage people—if they're not comfortable putting every little detail down, then don't. We just want to hear your story, hear what matters to you, hear what matters to your partners or your colleagues, et cetera.
Dr Lucy Burns (41:53) Oh, it sounds wonderful. It's not just women. It's men. It's, you know, men work with women. Men are often married to women. Men are parents of women. Most men have a mother. So they are the sons of women. So it's not just women that can contribute to Vital. And so people, if they want to go to Vital, how do they find it? Obviously, we'll put the link in. But yeah.
A/Prof. Erin Morten (42:26) Yes. Thank you. Otherwise, literally search Vital and Bespoke and/or my name and it'll come to my website. There's a click to join to register from there. You'll find the first page is semi-formal. Again, typical research speaks. But to ensure that you're comfortable, you click the consent on there and then you go through into the questions. And as I said, there's only two that are mandatory. Everything else is up to what people feel comfortable in answering. And again, far more than any other research study. I have questions peppered throughout going, what else should we be asking? Because I know that my experience is different to everybody else's. And it's really important that everybody has a chance to have a voice.Â
Dr Lucy Burns (43:11) I love that. I love that. Well, I haven't actually filled in the registry yet. So I'm going to go and do it. And I'm just going to go and Google Erin Morten Vital, because I suspect that will come up and then I can just fill it all in, which will be great. So my lovelies, I would be encouraging you to, if you feel comfortable, just at least go and check it out and add your voice to the picture. And Erin, I would just like to thank you for your work, your advocacy. Again, I feel late to the menopause party. I wasn't involved in any of the advocacy. I'd never know about it. Now I know. I think at the end of the day, what we all want for women and, in fact, for humans, we just want people to have choice and to be empowered to make their choice. Yes.
A/Prof. Erin Morten (43:51) Yes. One hundred percent. None of us. It's the phrase walk in each other's shoes, but making sure that people have a level ground and can make the decisions.Â
Dr Lucy Burns (44:01) Indeed. Indeed. All right, gorgeous woman. Go well. And I will talk to you soon.Â
A/Prof. Erin Morten (44:06) Thank you so much, Lucy. And to all.Â
Dr Lucy Burns (44:08) All right, lovelies, have a beautiful week. And either me or Mary will be back next week. Bye for now.
Dr Lucy Burns (44:17) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
