The GP Show

Professor Jayashri Kulkarni is one of Australia's leading psychiatrists and researchers specialising in women's mental health. She is the Director of the HER Centre Australia (Health, Education and Research for Women's Mental Health) and Professor of Psychiatry at Monash University. Professor Kulkarni's work focuses on mood disorders across the female lifespan, with particular attention to the neurochemical effects of reproductive hormones on brain function, including perimenopausal depression and premenstrual dysphoric disorder. She is the developer of the Meno-D rating scale and has been a leading voice for over four decades in the recognition and treatment of hormone-related mental illness in women.
In this episode, Dr. Ashlea Broomfield speaks with Professor Jayashri Kulkarni about the mental health impact of perimenopause. They discuss the role of oestrogen and progesterone as neurosteroids influencing mood, cognition, and behaviour; why mood symptoms often precede vasomotor changes by years; which women are most at risk and why; the distinct clinical profile of perimenopausal depression and how to avoid common misdiagnoses; and how to approach hormonal treatment in practice (including contraceptive options, transdermal oestradiol, micronised progesterone, and tibolone) alongside a review of the evidence around MHT safety.
RESOURCES
"The primary care management of perimenopausal depression" — Kulkarni J et al. Australian Journal of General Practice 2026;55(4). Read here
HER Centre Australia — Research, clinical resources, and the Meno-D scale: monash.edu/medicine/her-centre
Meno-D rating scale — Available via HER Centre Australia and as an appendix in the AJGP article above
Healthy Hormones — GP-led community, resources, and webinars: healthyhormones.au
Australasian Menopause Society — Evidence-based guidelines and resources: menopause.org.au
Monash University women's mental health short course — Via HER Centre Australia (
PMDD companion episode — The GP Show with Professor Jayashri Kulkarni (link once live)
Fast Facts in Sexual and Reproductive Health with Dr. Sara Whitburn — The GP Show 
 
TIMESTAMPS
00:00 — Introduction, Welcome to Country, guest bio
03:40 — Reproductive hormones as brain neurosteroids: neurochemical effects of oestrogen and progesterone across the perimenopausal transition
12:19 — Risk factors for perimenopausal mood sensitivity: early life trauma, the HPA/HPG axis, and recognising hormonal sensitivity in clinical history
24:28 — Diagnostic considerations: the Meno-D scale, distinguishing perimenopausal depression from MDD and bipolar disorder, and current gaps in psychiatric classification
37:29 — MHT safety: reviewing the 2001 WHI study, absolute and relative contraindications, and monitoring in practice
45:33 — Treatment approaches: hormonal contraception, transdermal oestradiol, micronised progesterone, tibolone, and tailoring to the individual
59:16 — Further resources and preview of the PMDD companion episode
 
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Study and learn lifestyle medicine:  Interested in whole of person clinical practice, research and careers that address the lifestyle and social determinants of illness and wellbeing, using lifestyle approaches, behaviour change, health coaching and implementation science?  Check out the JCU College of Medicine postgraduate degrees: Graduate Certificate, Graduate Diploma, and Master in lifestyle medicine.
Dr Sam Manger on YouTube: Using lifestyle as medicine: A new era in chronic disease remission and YouTube: Careers in lifestyle medicine
The 3 week online microcredential in Lifestyle Medicine and Mental Health: Life and Mind available here.

Dr David Fineberg is a General Practitioner and PhD candidate at the University of Melbourne whose research focuses on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID. He is the founding clinician of the ME Research Clinic (MERC), a translational research hub dedicated to advancing the diagnosis, evaluation, and treatment of complex post-viral syndromes through an evidence-based, patient-centred model.  His PhD is "Precision Medicine techniques In the treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS + Long Covid (PRIME)".
Episodes resources: 
MECFS diagnostic criteria from ME Research UK
DePaul Questionnaire
FUNCAP (Functional Capacity) Questionnaire
Open Medicine Foundation Resources and Clinical Guidelines
Visible App - wearable tech for illness, not wellness, designed for MECFS, POTS, EDS and Long Covid
RACGP Energy Limiting Disorders SIG and CPD CHECK
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If you find this podcast valuable, please help by rating the podcast 5 stars and leaving a review in your podcast app.
If you would like to request a topic, please contact us via contact@thegpshow.com 
Thank you for listening and your support.
... 
Study and learn lifestyle medicine:  Interested in whole of person clinical practice, research and careers that address the lifestyle and social determinants of illness and wellbeing, using lifestyle approaches, behaviour change, health coaching and implementation science?  Check out the JCU College of Medicine postgraduate degrees: Graduate Certificate, Graduate Diploma, and Master in lifestyle medicine.
Dr Sam Manger on YouTube: Using lifestyle as medicine: A new era in chronic disease remission and YouTube: Careers in lifestyle medicine
The 3 week online microcredential in Lifestyle Medicine and Mental Health: Life and Mind available here.

Many of us have patients with hypermobility and Ehlers-Danlos syndrome who we work hard to help. As our understanding of these complex multisystem conditions grows, understanding that it doesn't just affect joints but potentially autonomic function, cardiovascular health, digestion, and producing widespread, often debilitating pain, so too does the need for a broader range of therapeutic options. 
In this episode, musculoskeletal medicine specialist Dr. Rob Illingworth introduces prolotherapy and PRP as practical, evidence-informed options that could make a real difference to your patients' quality of life and function.
For anyone managing patients with hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorders, this one's essential. Dr. Illingworth unpacks the "perfect storm" of lax connective tissue, sensitized pain pathways, and complex comorbidities and adds a valuable option to your therapeutic toolkit for people presenting with these complex conditions.
...
If you find this podcast valuable, please help but rating the podcast 5 stars and leaving a review in your podcast app.
If you would like to request a topic, please contact us via contact@thegpshow.com 
Thank you for listening and your support.
... 
Study and learn lifestyle medicine:  Interested in whole of person clinical practice, research and careers that address the lifestyle and social determinants of illness and wellbeing, using lifestyle approaches, behaviour change, health coaching and implementation science?  Check out the JCU College of Medicine postgraduate degrees: Graduate Certificate, Graduate Diploma, and Master in lifestyle medicine.
Dr Sam Manger on YouTube: Using lifestyle as medicine: A new era in chronic disease remission and YouTube: Careers in lifestyle medicine
The 3 week online microcredential in Lifestyle Medicine and Mental Health: Life and Mind available here.

Dr. Sara Whitburn is the Medical Director of Sexual Health Victoria, Chair of the RACGP Sexual and Reproductive Health Special Interest Group, and a Senior Lecturer in Sexual Health at the University of Melbourne.  Her clinical and advocacy interests span STIs, unplanned pregnancy, genital health, menopause care, and long-acting reversible contraception (LARC) training. She is passionate about supporting health professionals to deliver great sexual and reproductive healthcare and enabling equitable access to care for patients.
Connect with the RACGP Sexual and Reproductive Health Special Interest Group:  Join the community (open to all RACGP members) by emailing gpsi@racgp.org.au. The group offers peer case discussion, newsletters, and webinars covering topics including PrEP, sexual pain, heavy menstrual bleeding, and more.
Resources
•          MAGIC App — National Cervical Screening Program guidelines (searchable): search "National Cervical Screening Program MAGIC App"
•          Australian STI Management Guidelines — sti.guidelines.org.au 
•          ASHM (Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine) — PrEP and DoxyPEP decision aids: ashm.org.au 
•          FSRH Medical Eligibility Criteria (UK Faculty of Sexual and Reproductive Healthcare, updated December 2025): fsrh.org 
•          RANZCOG Contraception Guidelines: ranzcog.edu.au 
•          Australasian Menopause Society — clinical resources and find-a-practitioner: menopause.org.au 
•          Sexual and Reproductive Health Australia (SRHA) / AusLARC scholarship: srha.org.au 
 
Timestamps
00:00 — Introduction & acknowledgement of country
01:00 — Guest introduction: Dr. Sara Whitburn
02:56 — Contraception: Pill Choice, Medical Eligibility Criteria Considerations, PBS Updates
12:18 — The menopausal transition: contraception vs. MHT, managing bleeding on MHT
23:10 — IUD pain management and post operative considerations
30:40 — Progesterone sensitivity and MHT options
33:00 — Monitoring patients on MHT
39:20 — Genitourinary syndrome of menopause and genital skincare
44:57 — Vaginal treatments vs. lubricants — clarifying the difference
45:42 — Libido: a biopsychosocial approach
49:00 — STIs: asymptomatic screening and approaching vaginal discharge
54:39 — Symptomatic STIs and trauma-informed examination
57:18 — Bacterial vaginosis and partner treatment
59:12 — STI prevention: PrEP and DoxyPEP
1:03:21 — Cervical screening: 2025 guideline updates and the MAGIC App
1:06:56 — Trauma-informed care in practice
1:10:51 — Medicare changes: LARC rebates and bulk billing incentives
1:12:58 — Why join the RACGP-SRH special interest group
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If you would like to request a topic, please contact us via contact@thegpshow.com 
Thank you for listening and your support.
... 
Study and learn lifestyle medicine:  Interested in whole of person clinical practice, research and careers that address the lifestyle and social determinants of illness and wellbeing, using lifestyle approaches, behaviour change, health coaching and implementation science?  Check out the JCU College of Medicine postgraduate degrees: Graduate Certificate, Graduate Diploma, and Master in lifestyle medicine.
Dr Sam Manger on YouTube: Using lifestyle as medicine: A new era in chronic disease remission and YouTube: Careers in lifestyle medicine
The 3 week online microcredential in Lifestyle Medicine and Mental Health: Life and Mind available here.

Ever found yourself staring at a workers' compensation or insurance form, pen in hand, quietly wondering what on earth you're supposed to write in half these boxes? You're in good company. Most of us learned this stuff the same way, watching someone else do it, nodding along, and then absolutely winging it the moment we were left alone with a patient and a certificate to fill in.
Yes, we know, workers' compensation and insurance sounds about as thrilling as a mandatory compliance training video. But stick with us.  Dr Rob Park sits down with Greg Spinda, specialist personal injury lawyer and, as it turns out, not nearly as terrifying as his credentials suggest, to work through real GP scenarios, tackle those form boxes that have been quietly haunting us, and explore how getting the details right from day one can make an enormous difference to your patients' outcomes. You might just walk away feeling like you finally know what you're doing.
...
If you would like to request a topic, please contact us via contact@thegpshow.com 
Thank you for listening and your support.
... 
Study and learn lifestyle medicine:  Interested in whole of person clinical practice, research and careers that address the lifestyle and social determinants of illness and wellbeing, using lifestyle approaches, behaviour change, health coaching and implementation science?  Check out the JCU College of Medicine postgraduate degrees: Graduate Certificate, Graduate Diploma, and Master in lifestyle medicine.
Dr Sam Manger on YouTube: Using lifestyle as medicine: A new era in chronic disease remission and YouTube: Careers in lifestyle medicine
The 3 week online microcredential in Lifestyle Medicine and Mental Health: Life and Mind available here.