Why women’s health is brain health

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Why women’s health is brain health

For centuries, medicine used to say that man = man. Studies were carried out on men, and when women were the focus of research interest, it was mostly in the so-called “bikini medicine”:

“For much of history, doctors have assumed that men and women differ only in the parts of their bodies covered by the small triangles of fabric in a bikini: our reproductive organs,” writes Lisa Mosconi in her book The Female Brain . – according to the neuroscientist, director of the Women’s Brain Initiative at Weill Cornell Medical College and deputy director of the first Alzheimer’s Prevention Clinic (clinic for the prevention of Alzheimer’s) in the USA, a fatal mistake that women still pay for to this day. She spoke to us about the background and explained why brain health is women’s health.

What is the main focus of your work?

Lisa Mosconi: I want to explore the unique strengths and threats of the female brain. Medicine has so far neglected the specific needs of women in this field. Women need personalized medicine and I’m working to ensure that they get it and that brain health is finally recognized as a women’s health issue.

Why is women’s health also brain health?

Women are twice as likely to be affected by anxiety disorders and depression, three times more likely to be affected by autoimmune diseases and diseases that affect the brain such as multiple sclerosis, and even four times more likely to be affected by migraines and headaches than men. Women are also more likely to develop meningiomas, the most common form of brain cancer; they are more likely to have strokes and are also almost twice as likely to develop Alzheimer’s, the most common form of dementia. Two out of every three people with Alzheimer’s are women. For comparison, breast cancer is undoubtedly a real threat to women’s health, but by comparison, women in their 60s are twice as likely to develop Alzheimer’s. Breast cancer is already seen as a women’s disease, Alzheimer’s is not. Our brains deserve more attention.

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Your book was created during the #Metoo debate – you write that we must demand women’s health because women are not only attacked and oppressed, but also neglected and sabotaged. When and in what form did you first notice this in your work?

From a medical point of view, women are overlooked and their needs are not recognized or taken seriously. This is because medicine and research for women are still based on what is known as “bikini medicine” – this assumes that women differ from men only in their sexual organs. That makes things problematic, because of course it doesn’t go far enough.

You write that menopause begins in the brain. What is that supposed to mean?

The fact that women, unlike men, have two X chromosomes not only affects our sexual organs, but affects all areas of our health, especially our brain. My studies have shown that women’s brains age differently than men’s, especially during mid-menopausal age. Hot flashes, night sweats, insomnia, depression, memory loss, word finding difficulties and mental drowsiness do not start in the ovaries, but in the brain. These are neurological symptoms; we’re just not used to calling them that.

Where are these symptoms coming from?

Our so-called sex hormones are not only there for reproduction, but also for brain performance. Estrogen is a neuroprotective hormone. It literally protects our brain from damage. Estradiol, the main estrogen, is the master regulator of the female brain. It fulfills so many functions that have nothing to do with having children, but everything to do with whether our immune system is working properly or whether we have enough energy in everyday life. Our hormones protect and shape our brain. The drop in hormones during menopause disrupts this balance in the system, triggering symptoms and sometimes various other diseases. This applies to women of all ages, regardless of whether they are 40, 50 or 60 years old.

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If you see these symptoms in yourself, what can you do to stop the process?

You can take care of your health, demand good medical care and adapt your lifestyle.

How?

In addition to menopause, the greatest risk factors include an unhealthy diet, diabetes, thyroid disease, depression, a disturbed hormone status, smoking – incidentally the number one risk factor for early menopause – lack of sleep and chronic stress. Many of these things can be worked on. But women still shoulder the lion’s share of the care work, for example looking after relatives in need of care, which entails a high level of psychological and physical strain, a high stress level and depression.

Are lifestyle changes more important than hormone replacement therapy?

I wouldn’t say more important, but the effectiveness is better researched and confirmed. In my research environment, there is uncertainty as to whether hormone replacement therapy is a good way to prevent Alzheimer’s. Some women benefit from it, some don’t. We need to understand why and how to use this information to make general statements about brain health. But we do know for sure that certain lifestyle modifications lead to a reduction in the number of Alzheimer’s cases.

Lifestyle changes are difficult to implement. Isn’t that shifting the responsibility onto the patient?

No, from my point of view this is a huge opportunity for women and good news that you can do something yourself.

Which myths about women’s health would you like to debunk with your research?

That women are persuaded that after 40 you are no longer young and that they should suddenly think about Botox. This is ridiculous and it’s time we focused on what really matters and what we can do mentally and intellectually. No matter what age.

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