Show #375 It’s Menopause’s Moment: A new conversation about midlife, with Lisa Mosconi PhD

                 

About this show:

Lisa Mosconi PhD, renowned neuroscientist with over 200 published papers, says: Menopause is having a moment. She’s right, and she’s written the book to meet that moment. The Menopause Brain, a book being celebrated around the world. Gen X has arrived mid-life, with all the state-of-flux symptoms that come with peri-menopause and menopause and said: Enough! Why are we not talking about this? Why are we being gaslit in Dr’s offices for our symptoms and being offered multiple medications for anxiety, depression and pain, but not having a conversation about what might help us far more, due to outdated medical research claims of overblown HRT risks? We also have been robbed of the exciting potential for embracing the rite of passage into a new chapter, from a spiritual and personal growth perspective. We discuss: 

  • Menopause is not a disease, and it’s not just ‘aging’ – it is a neuro-endocrine transition: A biological event
  • What’s happening during this transition and why sex hormones aren’t just sex hormones
  • The risks that increase from midlife for women including a discussion around Alzheimer’s Disease
  • The benefits of ‘getting to the other side’ from a resilience and cognition perspective. 
  • Was HRT risk ‘fear’ in the late 20th Century overblown? 
  • Lifestyle considerations to support us during our transition
  • Validation for your own experience: A critical piece in the transition

Connect with Lisa on the following platforms:

Website lisamosconi.com

Instagram @dr_mosconi

TikTok @lisamosconiphd

 

Grab a copy of her book, The Menopause Brain available in Booktopia: https://bit.ly/themenopausebrain 

 

Thank you to this month’s sponsor for partnering with our show and helping you make your swaps with their special offer: 

 

Ausclimate giving you 10% off their Winix Air Purifiers and Dehumidifiers at ausclimate.com.au. CODE: LOWTOXLIFE at checkout

Be sure to join me on Instagram @lowtoxlife and tag me with your shares and AHAs of this week’s episode.

Alexx 

Founder of Low Tox Life and the Low Tox movement

@lowtoxlife

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Title show track, by LIOR.

Love the podcast music? You will hear excerpts from Lior’s track “Caught Up”  – go check it out on iTunes or Spotify if you want to hear the whole song or album, Scattered Reflections. Co-written with Cameron Deyell, it’s a great song and I love the reflective energy of it – perfect for the show, right? Enjoy. Lior is always touring, so do check out his website. It is wonderful to hear him sing live, trust me.

Low Tox Club – The place to bring your low tox life to life.

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About Lisa Mosconi, PhD

 

 

Lisa Mosconi, PhD, is an associate professor of neuroscience in neurology and radiology at Weill Cornell Medicine and the director of the Women’s Brain Initiative and the Alzheimer’s Prevention Clinic at Weill Cornell Medicine/NewYork-Presbyterian Hospital. A world-renowned neuroscientist with a PhD in neuroscience and nuclear medicine from the University of Florence in Italy, Mosconi was listed as one of the seventeen most influential living female scientists by The Times and called “the Mona Lisa of Neuroscience” by ELLE International. She is the New York Times bestselling author of The XX Brain and Brain Food.


Connect with Lisa on the following platforms:

Website lisamosconi.com

Instagram @dr_mosconi

TikTok @lisamosconiphd

 

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Transcript:

(0:00 – 1:56)

Are you feeling in a state of flux in midlife and asking big questions as you turn to social media to look for answers? Maybe you’re looking at research, chatting with different health professionals. Check out something I said in today’s show at one point. Well, do I just go in this wild and naked into the field and explore my deeper self or do I whip on an estrogen package and get to work? Welcome to the Lotox Life Podcast.

 

I’m Alexx Stewart, your host, founder of the Lotox Movement, and I’m thrilled to have you here for this epic conversation with renowned neuroscientist, Lisa Moscone, PhD. She’s an associate professor of neuroscience in neurology and radiology at Veal Cornell Medicine and the director of Women’s Brain Initiative and the Alzheimer’s Prevention Clinic in New York at the Presbyterian Hospital. She is a woman on a mission.

 

She’s published over 200 research papers in her time, and at the end of this hour of menopause power, and I include perimenopause in that, you will feel so much more in the know about what is going on with our brains. We flesh out, I should say, some pretty cool analogies for what’s going on and how it feels. We even liken this stage to a messy breakup, and I just know it’s going to be the relief that a lot of people need as we navigate this topic.

 

(1:56 – 9:01)

I know GenX has arrived at menopause and gone, excuse me, what? Why aren’t we talking about this? There’s so many people in a state of flux, and of course, we often tend to externalize when we panic about not knowing ourselves anymore and look for answers out there. As I said in that funny intro phrase that you’ll hear in the interview, it feels like you have to choose a camp. Do I do the wild and free and rituals and spiritual side of this, or do I whack on an estrogen patch and continue on with my life? Is there anything in between? Of course, there always is.

 

There’s what you want and what you deserve to have based on what your needs are. We explore everything today. We explore natural ways forward.

 

We explore HRT, what we know about that science. We explore what’s happening with our sex hormones and why sex hormones isn’t even an accurate description of sex hormones. We look at the impact on the brain of this midlife transition, and we look at where else in a woman’s life, and it’s quite a unique biological event that not many people, not many species go through, where else this is happening.

 

Of course, it’s puberty, pregnancy. Lisa helps us step through what is happening and even shares with us a couple of things she’s doing to head towards this transition herself. She even gives a shout out for the low-tox movement at the end when we start talking about beauty products.

 

I’m going to hook into that show in a little minute. Of course, I’m also going to remind you that we have two offers. Number one is 12% off all new systems from Waters Co, my favorite water filter brand.

 

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I’ve used it to travel with for years. It is a fantastic water filter and it’s a much more accessible price point. There really is something for everyone wanting to look at their water.

 

We have our major sponsor Oz Climate continuing to give us 10% off Winix Air Purifiers and the dehumidifier range. Mold, for example, if we’re thinking about purifying the air and dehumidifying is micro estrogenic, meaning it can fiddle around with our estrogen signaling and block or mimic it kind of the same way that some of the hormone disruptive chemicals can in personal care and cleaning products. So dehumidifying, keeping a nice dry environment and air purifying can be excellent adjuncts to the perimenopause transition.

 

Don’t you love the way I found a segue there? So your code is LOTOXLIFE 10% off. Both of those offers are for Aussie listeners. I’m sorry guys, but the good news is, is everyone around the world can benefit from this amazing podcast with Lisa.

 

Enjoy. Hello, Lisa. How are you? Good morning.

 

I am good. Thank you. How are you? I’m great.

 

And well, do you know what the real answer is? The real answer is, thank God I’m talking to Lisa Mosconi this morning because I haven’t slept more than six hours in two weeks and I’m 48 years old and I’m sure there are women out there who are identifying with this. And it’s such an interesting phase, perimenopause, intermenopause. And I love that we have the chance to look at the frontline science that you are doing.

 

And I call it the front lines because almost in the sense of a battleground, women have been cut out of learning about their own bodies. Grandmothers and mothers, especially in Western cultures that don’t have Indigenous ties and a sense of structure around elders and wisdom and sharing through stories. Who knows what our poor grandparents were going through? I asked my mum just last week, so why did you get that hysterectomy in your early fifties, mum? What was it? And she said, oh, I had fibroids.

 

And I thought, oh, okay, so let’s just rip it out. And, you know, for some women that can be the end solution, but it feels like we are at a dawning of a very exciting time where we are talking more, where doctors are frustrated they can’t help their parents with the conventional ways they’ve been taught. So they’re disrupting the model and you are helping us see how impactful our brains are in all of this.

 

So I’m going to ask you, Lisa, you’re not in the year five classroom where the teacher goes around and says, what would you like to be when you grow up, Lisa? And you put your hand up and you say, I want to write a book about metaphors. Like, was it always about the brain for you? Did you have a curiosity about the brain and women’s science and health came later? Actually, yes. Yeah.

 

(9:01 – 11:29)

It’s going to be maybe a little bit of a boring answer. It’s not boring. I think figuring out the why behind people is always fascinating.

 

So I grew up into science. My parents are nuclear physicists. Wow.

 

Yeah. And so are my relatives, they’re physicists. And a lot of conversations around dinner time were about positron emission and accelerators.

 

My mom used to go to the CERN in Geneva, the huge accelerator. So there was a lot of talking around experiments and kinetic modeling. And yeah, so I grew up into science.

 

I always kind of assumed that I would be a scientist myself. And around when I was maybe around six or seven, I told my grandmother that I wanted to be a brain. And then when I actually went to college, I realized, actually, you know, I’m not cut out to be a psychologist.

 

But I might be able to do some biology, neurochemistry, neuroscience. And that became really, to me, is probably the thing that I’m most interested in. And so effectively being a neuroscientist for a very long time.

 

Yeah. And it’s it’s interesting that you said I’m not cut out for because then it got me thinking, well, what is the difference? And the difference is like the psychologist is working in the business of the brain, the everyday story about what’s going on with our relationships and how we react, emotions, feelings. And you are working on the business of the brain.

 

You’re in the like you’re in the engine room and they’re in the showroom. Right. So it’s yeah, I said it’s a lot more what I do is way more biology, like molecular.

 

It’s there’s a lot of mathematics involved. There’s a lot of neurochemistry used to be my absolute favorite class, neurochemistry, neurophysiology. So there’s a lot of chemistry I was saying what I do still today.

 

And what really interests me for whatever reason, it’s always been yeah. So I started doing research when I was 18. I was very, very fortunate.

 

(11:30 – 11:42)

So my mom used to teach nuclear physics to students who would babysit me. Oh, wow. You really were surrounded by science.

 

(11:43 – 11:50)

Surrounded. Yeah, it’s the perfect word. My babysitter would tell me about her boyfriends and what was happening with her best friend.

 

(11:51 – 13:44)

You were getting science lessons. Yeah, I was getting a lot of that. I mean, my bedroom when I was little had like an enormous whiteboard, like an entire wall was a whiteboard so that people could just do their homework.

 

You know, I was like at the bottom doing my little sketches and trying to replicate my mom’s differential equations with all the integrals and exponentials and whatnot. And yeah. And but so the students, then some of them transferred to nuclear medicine.

 

She’s that branch of radiology that I have a PhD in now, where you use nuclear physics to study biochemistry and physiology. So there’s a lot of imaging that’s been done using tracers and radioactive isotopes effectively that go inside your body and your brain and then allow you to measure all these different things where I’m sure most people may have seen those brain scans where the brain looks like yellow, red, blue, green. Right.

 

Yeah. So those are positive emission tomography or PET scans, which is what I specialize in. And I’ve been doing this for a long time.

 

And at what point did you start to think about the underrepresentation of women in this research and that there might be a point in spending way more time on the female brain to try and figure out some of the differences? Yeah, it came in stages. I think around the same time that I was in college is when my grandmother, coming back to my grandmother, she started showing signs of cognitive decline, which over time turned into a diagnosis of dementia. That was very heartbreaking.

 

(13:45 – 16:56)

So heartbreaking. I share that same observation, unfortunately not through the eyes of science. But for me, it was she burnt her chocolate cake and this woman is like famous for her chocolate cake and she burnt it.

 

And then the next time it sunk in the middle and it was always perfect. And then the next time it was overcooked. And so she was always apologizing for her cake all of a sudden, instead of everybody going, oh, I just, it’s the best.

 

And I remember being in my early twenties and thinking, what is wrong? I didn’t know what was wrong, but I just knew something was wrong and I was sad. And so I remember thinking I now need to learn everything this woman knows about making desserts because she was so famous for it. And of course we know sugar isn’t ideal for brain health.

 

And retrospectively, I think about some of the things I could have helped with now that I’ve interviewed over 400 doctors. But I think it’s an interesting thing to see our loved ones decline. And so when you saw that in your grandma, talk to me more about your journey there.

 

Well, it wasn’t just my grandma. She was the first, but she also had two younger sisters who also showed exactly the same type of cognitive decline, almost the same type, and eventually developed dementia, whereas their brother did not, even though they all lived to the same age. That was really quite puzzling.

 

And I had just started my PhD in neuroscience, but also nuclear medicine imaging. And I just so happened to be studying Alzheimer’s disease and dementia for my PhD. Actually, even before my PhD, I was doing my one year mandatory training and fellowship in nuclear medicine and in neurology.

 

And that’s when she started clearly manifesting cognitive decline. So my grandmother was extremely highly educated. She was one of the very first women to go to university in Italy ever.

 

Yes, she was extremely intelligent, and she was able to compensate for a very long time. So she was a little bit masking pathology until it just crashed. And that was really quite alarming.

 

And so I started by asking these questions to my PhD mentors and my colleagues, and they had some interesting theories that we started researching right away. But it’s only when I was in New York, so I transferred to NYU Medicine for my PhD. And then I was hired right away as a faculty member at NYU in psychiatry.

 

(16:57 – 17:17)

It was working great because at that time, a lot of psychiatrists were actually doing research on Alzheimer’s disease, whereas today it’s more neurology. Yes, it’s not seen as a mental illness so much as a biological decline now, there’s been a differentiation. Yeah.

 

(17:18 – 19:55)

Yes. And it was very fortunate that I was working with a professor, Dr. Moni Deleon, who’s really a pioneer in this field of the early detection of Alzheimer’s disease, and was really, really open to my interest in sex differences and Alzheimer’s, where really no one was looking into that. Even though we’ve known since 1994, that after aging itself, being a woman is actually the strongest risk factor for Alzheimer’s disease, even more than genetic risk factors.

 

But people just kind of put it away by saying that that’s just that women live longer than men. And I got it forever, every time I was like, well, why don’t we look at this and that? And they’re like, well, you know, yes, it’s interesting. However, Alzheimer’s is a disease of old age, and women live longer than men.

 

So there’s really there’s really not that much that we can do about it. And it’s in my very early work was to show that Alzheimer’s is not a disease of old age. But in reality, it’s a disease of midlife with symptoms that become clinically evident in old age.

 

In other words, the process, the biology and the pathology of Alzheimer’s disease starts in the brain years, and sometimes decades before the damage is severe enough that people start showing symptoms that lead to a diagnosis of Alzheimer’s disease. It’s like heart disease or cardiovascular disease, right? That usually starts with an accumulation of plaques inside the artery walls that build up slowly over time, increasing the risk of a heart attack. It’s not just overnight, you get it’s a progress, it’s a silent and quite insidious process that can take a long time.

 

So that was helpful for many reasons, including that it changed our question, right? Because at that point, you can’t dismiss my question by saying just that women live longer. The question now is changing to well, if Alzheimer’s starts in midlife, then what happens in midlife for women and not for men that could possibly explain the greater risk of Alzheimer’s in women. And so there are many, many things that could go awry and there are many risk factors that are being investigated.

 

(19:56 – 22:38)

And one of those that we’ve been really focused on for menopause and for women is menopause. So then what we’re looking at right now is menopause, because the research is suggesting the list that menopause may be a female-specific risk factor for Alzheimer’s disease. But also, we’re learning that menopause is actually quite an interesting neurological event that really needs to be better researched.

 

So that’s what we’re doing now. So fascinating. And something that I shared a year and a half ago now is that I had an ADHD diagnosis.

 

And while that helped explain my entire life, my question became, why now? Why did I hit a breaking point? Why did we get a dog and all of a sudden I got depression from having this one extra tiny thing? I mean, it’s not tiny, dogs are sometimes like a kid, but you know, you feed them, you walk them, they sleep. Like it is actually far more simple than a human child. But I lost it, fell to pieces.

 

I was fascinated by this. And that was what originally drove my ADHD diagnosis, which is an accurate and retrospectively looking at life, completely accurate diagnosis. But I suspect that the drop in estrogen meant that I no longer had the scaffolding that helped me be a high functioning neurodivergent person, and actually just ripped the bandaid off my brain and said, Hi, you actually find a lot of things quite tricky in the details.

 

Dr. Moscone, am I at all barking up the right tree here with why so many women tend to eventually desperately need an ADHD diagnosis? Could this actually be a part of why? Because we can no longer actually be supported by the estrogen in the brain type we have. I think that’s plausible. What we’re learning is that menopause is a neurologically active state, which means that as a woman starts transitioning to menopause, the neuroendocrine system transitions as well, where your brain is impacted just as much as your ovaries.

 

(22:39 – 24:33)

And something that is important to understand also in terms of an ADHD diagnosis was also for depression, for anxiety, for brain fog, for a lot of things that become actual risks and issues in midlife for so many women, is that these hormones that we define as sex hormones are actually also brain hormones. And what happened is that estrogen, progesterone, testosterone were discovered back in the 1930s by scientists that were studying fertility and reproductive function. And so when they found the link, they said, Oh, great, these are sex hormones.

 

We need to consider them for pregnancy, for puberty, for menopause. But they missed the other half of what these hormones actually do, or perhaps even more than half. And it was only in the 1990s, the scientists, brain scientists, discovered that those same exact hormones that are so crucial for reproductive function are also just as crucial for the functioning of our minds.

 

And estrogen in particular, which is the hormone that really bottoms out after menopause, but most importantly, starts fluctuating and is all over the place during perimenopause, which is the transitional phase before the final menstrual period, is really important for women’s brain health. It’s called the master regulator of women’s brain health, because it’s like an orchestra conductor that’s involved in so many different things and can just carry them all out really smoothly. It supports neuroplasticity, it’s a neurotrophic hormone, so it gives support to your brain cells.

 

It really improves blood flow to the brain. It supports energy, functionality, and activity inside the brain. It supports the synthesis of neurotransmitters.

 

(24:34 – 28:34)

So it does so many different things that when estrogen, first of all, starts just being all over the place and then eventually kind of retires, that leaves your brain in a state of flux. You know, the orchestra is still playing, but the tune is not quite the same. And what we find is that that is a state of vulnerability for the brain, which does not mean that we’re getting sick or that the brain is sick, but it is more vulnerable.

 

So if you have a predisposition, let’s say to ADHD, the transition to menopause is when you may actually get a diagnosis. You have a predisposition to depression, menopause or the perimenopause is when you may start having the symptoms of depression. And the same for Alzheimer’s disease, what we find is that for women with a predisposition, the transition to menopause is when we see the signs of Alzheimer’s in the brain, which does not mean that every woman is going to get Alzheimer’s, right? It’s a risk factor.

 

Menopause is a little bit like an activator for whatever medical risks you may have that involve your brain. Does it make sense? Yeah, yeah, absolutely makes sense. It doesn’t cause any diseases.

 

It’s more like a risk factor, which is a bit different. And so the role of, is it almost like the hypothalamus and it’s looking for the connections it’s started to really rely on and depend on all these decades since puberty. And it’s like, where are you guys? And it’s okay if your child is missing for like an hour, you’re a little bit stressed, but you’re like, yeah, look, I’m sure he’s just ended up going off to have a drink at the train station with a friend after school, he’ll be home.

 

But then like it’s the second hour and the third hour, and then it just gets more and more panicky. And then I can almost picture this situation where there’s so much energy spent on trying to look for the connections that have been there forever that all of a sudden aren’t, that it takes away a lot of brain energy from other things, which is why women can often feel like we’re losing it a bit in this period of life. That’s an interesting analogy.

 

I don’t know. I work in analogies to try and understand really complex things. Yeah.

 

Another way to think about it, maybe as an analogy, is that estrogen alone, hormones alone don’t really matter. They are only chemical, I mean, not only, but they’re chemical messengers. And the way they work is that they need to attach to a receptor.

 

And women’s brains are full of estrogen receptors. And everything works great for as long as you have enough estrogen to, we say, saturate the receptors. Make them happy.

 

Yeah. To make them happy. So the receptors are happy.

 

You have enough estrogen. So we can think of that as a relationship, like a romantic relationship, right? Where at some point estrogen just doesn’t quite show up. Estrogen’s ghosting its receptors.

 

It’s ghosting the receptors. And the receptors are with them, and what’s happening? So then when estrogen comes back, the receptor really latches into the estrogen and tries to keep it there for longer. Oh, and it turns into the needy person in the relationship.

 

This brings us close to perimenopause. But then when estrogen starts missing for a while, the receptors are kind of trying to first compensate for that. And then eventually they just shut down.

 

And it’s the end of the relationship. With the difference that the ovaries may close down shop because they have to, right? They run out of follicles and women start their non-reproductive phase of life, but we need to have brain to function. And so what the brain does, our brains are exceptionally smart organs.

 

(28:34 – 30:04)

I think we don’t fully appreciate how adaptable they are. And so the brain kind of rewires itself, the switches to other fuels and other forms of energy support and other mechanisms to just keep going. So I think it’s really important to realize this, that yes, the ovaries can do whatever they want, but menopause is actually different.

 

It takes a lot longer to go through it. The brain is still transitioning for like years after the final menstrual period, which is why so many women still have symptoms of menopause, the hot flashes, the eye sweats, the insomnia, depressive symptoms, the brain fog, the memory lapses just keep happening for usually four to six years, sometimes just one. Yeah.

 

There’s nothing more alarming than that first Google search. How long is this going to, when you see the four to eight years and you’re like, hold on, excuse me, what? Maybe, maybe I’ll use a different browser and just look that up again. Oh, okay.

 

No, really? Yes. Yeah. But that’s actually before the final.

 

So the transit, the peri-menopausal window ranges between two and 10 or 11 years with an average of seven. But then once you’re done, you no longer have a period. Your brain is still in transition for another six years or longer.

 

My goodness. We are on the ride of a lifetime. That is a lot.

 

(30:04 – 31:49)

It’s literally a lifetime. Number one, be aware, right? Otherwise it just feels very scary. It feels like the rug has just been pulled out of you and you have no idea what’s happening.

 

So we need to know that the actual real timeline, because the symptoms may happen to you when you have a cycle. You just have no clue why you’re having this syndrome. So it’s really important to know that to avoid fear.

 

Yes. Because the fear activates a danger response, nervous system gets involved, and then that’s when things can go really haywire. Yeah, absolutely.

 

And then also realizing that if it takes years to get through this transition, we may as well invest some time and resources into making it a little bit easier on us. And so it’s important to talk about solutions. And I really personally resent it when people just kind of dismiss menopause as something that just happens to you.

 

So these two shall pass, you know, just green and berry. I find it to be absolutely heartless when so many women struggle and receive no validation for their experiences. They actually feel almost like, well, maybe I should just stop talking about it instead of receiving support.

 

Well, I think that is the history of women’s health and medical sexism in a nutshell, really, isn’t it? Oh, for sure. I think it’s so evident when it comes to menopause, there’s ageism and sexism that compounded together give us menopausism. There’s this misconception that menopause happens to you when you’re old.

 

(31:50 – 33:28)

That is so not true. The average age is 51, 52 in Western country, but it’s 49 globally, which is not old by standards. And then you’re going to spend over 30% the rest of your life in a post-menopausal state and your brain needs support.

 

I think that’s the bottom line, not all women’s brains, but many. And why not invest in taking care of your brains and prioritize your health and self-care? Because look, your healthy midlife is actually the best predictor of your health in old age and for the rest of your life. So midlife is a time where we need to take care of ourselves as women.

 

We have to. And it’s, it almost feels like that is quite a cruel and stressful statement in itself, because no, no, no, no. I know you’re not trying to be mean, Lisa.

 

You are literally, you feel like one of the kindest people I’ve ever met, but I feel that energy. I promise. But I mean, in the sense that if we look at the midlife of women, we are often in career peaks.

 

We are often managing the interesting journey of teenagers or early adulthood in children. If we’ve had children, we might be also managing elderly parents. There may be quite high mortgage repayments like there are in modern life.

 

(33:28 – 33:55)

It almost feels like modern life does not suit the menopause transition. It’s almost like they’re mutually quite, yeah, dissonant, really. Yeah.

 

You know what I’ve learned though, that for many women, menopause is, is a little bit of renaissance of sorts. I was going to talk about this. Yes.

 

(33:55 – 35:32)

I keep hearing this, that once you’re done, you’re stronger than ever before. You’re more, you’re more resilient. You feel more empowered.

 

You have boundaries. You’re not scared to say no. A lot of women will report that after you’re done with menopause, you basically start giving fewer F words.

 

And I think that’s something to look forward to in a way, because, you know, it’s important. I think it’s important to take control. Yeah.

 

And so in our brains, what is, why do you think we give fewer Fs? Like, is it because, is it because the estrogen is leaving the building, the lovey-dovey hormone? Maybe the testosterone. Maybe the testosterone, like whatever. So, I mean, you won’t be surprised to learn that there’s very little research done, right, on the post-menopausal brain, but whatever little research has been done has shown something that I think is really interesting, which is that during the menopause transition, there is actually a rewiring in the brain.

 

There is a remodeling that’s taking place. And that ends with something really important, which is that the emotional center of the brain is called the amygdala. It seems to be very selectively downregulated in a way where if you receive, something good happens to you, the amygdala is just as happy.

 

(35:34 – 38:34)

But when something negative happens to you, when something upsetting happens to you, it doesn’t react as strongly. It has a more blunt, blunted response to negative sources stimuli. And that’s a hint to the fact that post-menopausal women tend to score higher on both empathy, but also emotional control.

 

And this seems to be, it was found in the United States, it was found in Europe. So it seems to be, I don’t know if it’s a common response, but it was a significant change, but a significant difference relative to the pre-menopausal brain. Yeah.

 

And it speaks to how unwarranted ageism is of older women in the workforce, because it, you know, why would you get rid of people or not hire people who are the calmest, most collected and the most experienced they’ve ever been to lead and work in organizations? It brings up like the potential for truly understanding the menopause brain, I think is infinite in terms of how we can all understand each other better and how we can maybe finally start to let go of some of those biases that have existed for far too long. Yeah. And something that it’s important to me to really underline is, you know, we’ve done this research with brain scans.

 

I don’t know if you’ve seen it, but we’ve shown how the changes with menopause and they always have to say, these are not deficits. It’s a change in energy levels. So it does not mean that women are impaired.

 

In fact, if you look at cognitive performance, cognitive performance, yeah, may decrease just a tiny little bit during the transition to menopause, but still women outperform men on cognitive testing before and after menopause, which means that if you feel like your cognitive performance is not as strong as it used to be, or if you’re having a little bit of a hard time multitasking, if you’re not remembering things as much as you used to, now that you’re postmenopausal, you function just as well as a man. Well, that is reassuring to know. And did you see neurosexism, I love that term in your book, throughout the infinite, like the start of your research and starting to ask these questions and why don’t we know about this already? Like, was it really just so obvious once you clocked it? Well, I think it’s very obvious that the vast majority of research had been done on men.

 

(38:34 – 39:39)

And that even today, the vast majority of brain studies lump men and women together, and then remove the effects of gender using statistical procedures. But there are very few studies that are able to look at women as being different from men. So that’s one issue.

 

The other issue is that, not now, but I would say up until maybe 15 years ago, there was a tendency to, whenever sex differences were investigated, there was a tendency to then interpret the results under a behavioral lens. Like, people would say women’s brains are better interconnected than men’s brains, which is something that we know to be the case. Just stop there.

 

Just say, this may reflect women’s greater ability to multitask. Or men’s brains have bigger hippocampi than women’s brains. That’s clearly proof that men are better at driving.

 

(39:40 – 40:25)

You know, it’s kind of sad. It’s like, what are you talking about? Did you measure driving? No, so shut up. But it happens a lot.

 

Yeah, it sounds like the clickbait of science right there. Yeah. And it’s not just the media over interpreting scientific studies.

 

It’s that scientists would also try to offer some kind of behavioral correlate. And now we know better, and we don’t even try to do that. I’ve never done it, obviously.

 

My research is very biology driven. I don’t have anything to say about behavior. What I would want to underline is that when we look at sex differences in the brain, it’s not to enforce gender stereotypes.

 

(40:26 – 41:07)

Right? Nobody’s saying that if your brain as a woman is a bit different from a man’s brain, that means that you are more intelligent or less intelligent, or you have more potential or less potential. That’s nonsense, right? That’s pop culture. What we’re looking at is actual biology.

 

And that is important to know, because our brains are not the same as men’s brains, which means that maybe some medications will work better for men than for women. Maybe some medications will be metabolized faster by men than by women, which we know is the case. And it’s a good reason to start doing gender studies, because then you will be able to come up with better solutions for everyone.

 

(41:08 – 41:31)

Yeah. And more accurate risk factors, side effect profiles, the list goes on. Exactly.

 

So what we have done and what others are doing as well is that we’re looking at risk factors for Alzheimer’s and dementia, for instance. And what we’re finding is that for men, the risks are more often than not cardiovascular. So heart disease, smoking, high cholesterol level.

 

(41:31 – 45:44)

But for women, the actual stronger risks, at least in our research, are more metabolic and hormonal. So it’s having a hysterectomy or an oophorectomy is whether you go on hormone therapy or not for reasons and whether you have thyroid disease or whether you have insulin resistance. So there’s slightly different pathways.

 

So they’re not mutually exclusive. Of course, these factors are important for men and they’re important for women. It’s just that the relative importance seems to be a little bit different.

 

And I wanted to ask you, Lisa, because in the book, and I don’t want to do a chapter by chapter and let’s talk about the book the whole time, because the book is excellent. Everyone should read it. That for me is a given.

 

So I want to kind of dig in between the lines of some of the things you talk about. Did you see Naomi Watts? Sorry? Naomi. Yes.

 

Beautiful quotes and the co-writers. I know. Well, Australians are pretty cool.

 

Yeah. Look, I so I want to ask about the almost the the opportunities to support women through this phase. I love that you, of course, mentioned self-care.

 

And yes, it can seem really hard on the best day, but it is a priority. But I also wanted to speak to something you said around the invitation we almost have to explore what it looks like to not care about all the things so much and the freedom that will come with that as we move to the other side. And and rather than that being a bad thing.

 

But I also then wanted to ask you about medication support, because you do talk about that in the book, medication, lifestyle, all the different options. And you’re certainly not trying to point anyone in any one particular direction, because you’re completely objective about the science, right? Yeah, I hope so. Yeah, it comes through.

 

And so I guess my question is, there is a lot of talk about all the terrible things that increase in menopause at the moment, almost in an evangelical way, which I completely understand where that’s coming from for the female doctors who are leading that conversation, because I can see that they have themselves felt shut out in their medical studies, as well as shut out as women in midlife and beyond. And they want the best for their patients. I really appreciate the passion from which that stands.

 

But I also have a question around how in a very loud world on the internet, where there’s that conversation, and then you look over here, and then there’s a whole bunch of beautiful wild women connecting to the moon and poo pooing all of the HRT conversation. And the HRT people are like, why wouldn’t you make the most of this? It’s almost like this polarized argument has manifested itself online. And I would say the bulk of the women behind watching both are now more confused than ever about what do I just go in this wild and naked into the field and explore my deeper self? Or do I whip on an estrogen package and get to work? Like, how do we find our individual way through this? You’re laughing at me.

 

I love it. And, and feel empowered, instead of feel like we’re just hooking on to one person’s way of seeing this and making them our guru. You know, do you understand what I’m trying to ask? Totally.

 

You know, I, I normally stay away from social media. It’s probably a good idea. Yeah.

 

(45:46 – 46:54)

Yes, I noticed that too. And, you know, I’ve been in this field for a long time, and menopause is having a moment. It is, which is great.

 

But the moment can be confusing because there are so many hot takes, right? Yes. And they, I think that comes down to whether professional societies have done a good job or not. Everybody happy and up to date.

 

I mean, not just the professionals, but the FDA and public health agencies. And I think what I know a lot of the people that you’re saying, these female doctors are now coming and trying to revamp menopause and suggest hormone therapy. And I feel their frustration.

 

Me too. I actually really adore the emancipatory feeling of their message. It’s wonderful.

 

It just feels like liberation. It does. However, you also want to be realistic about not over medicalizing.

 

(46:54 – 50:28)

Yes, that was kind of where I was going. Like, where do we draw the line here? Because it sounds like there are benefits to just letting it all peter out and the big breakup between our receptors and our estrogen finally occurring and creating more peace, clarity, and relaxedness than we may have ever known. Well, I will, you know, it’s just important to understand that that’s an average reaction, right? In a study, you always look for the average behavior and the average outcome.

 

And in science, we unfortunately do not look at outliers or the extremes. So there are some women who maybe reach nirvana, but there are some who clearly don’t. This range of symptoms and risks is just not formalized in medicine.

 

So what I think needs to happen is two things. And this is my take, and I’m open to discussing it, obviously. This is my take from an objective perspective.

 

I think as a scientist coming at it, I have to be very objective and just right-minded. So number one, we need to work on our vocabulary, because the lack of a clear definition of what menopause is and isn’t, I think, is harming women. Because people will say, well, menopause clearly is a pathology, but it’s a disease because it gives you all the symptoms that are really difficult to navigate and also increases the risk for a number of things.

 

But other people will say, well, actually, it’s not a disease because all women go through menopause. And when something that is meant to happen happens, right, that’s the opposite of what a disease might be. But that is kind of downplaying the relevance of the symptoms and the possible risk.

 

If you say it’s just aging, you’re actually putting women at a disadvantage because there are risks and there are symptoms they need addressing that we were talking about. This is a difficult state for many women. So as a scientist, I have come up with a scientifically accurate definition of what menopause is and is not.

 

Actually, a lot of my friends who are feisty of a kind on social media really loved it, and they started using it right away, which is that menopause is not a disease and is not just aging in quotes. It’s actually defined as a neuroendocrine transition state. Why is this important? Because it’s unique in biology.

 

It belongs to a unique category of events called neuroendocrine transition, brain ovaries, brain hormone transitions. They only include three events for women, puberty, pregnancy, perimenopause, and then there’s andropause for men. And what it’s important to understand is that at these turning points in a woman’s life, there are changes that are happening in the body and the brain that yes, they’re expected to happen.

 

They are biologically programmed. However, they do increase vulnerability to certain things, whether osteoporosis, whether heart disease, whether potential dementia, whether just depressive symptoms and brain fog. So those cannot be dismissed as just aging because that brings us back to the 19th century where women were either institutionalized or not helped at all.

 

(50:29 – 51:56)

So it’s important to understand, yes, it’s a biologically expected event. There’s no reason to fear it. It’s not an enemy.

 

It’s not here to kill you. It’s not an alien event. It’s something that we know should happen.

 

There’s a reason for it. However, it’s no walk in the park for men and women. Therefore, we do need support.

 

Number two, there’s a range of symptoms that is not too different from pregnancy in a way. The mommy brain we now realize is a brain that is evolving, is rewiring itself to enable new mothers to be more empathic and more able to really read people’s minds because you have this little baby who can’t talk to you for a really long time. And human children, human babies are really helpless for a very long time.

 

Mother, your brain needs to become more intuitive. It needs to become certainly more resilient. And that means that the brain has to change the connectivity between different brain regions for that to happen, for the mama bear to come out.

 

At the same time, that can bring on cognitive changes, mood changes, sleep changes, changes in libido, which is exactly what happens in menopause. On these pregnancies, everybody’s happy, but then postpartum hits, right? And for some women, it’s no big deal. For some women that are mild depressive symptoms, the baby blues.

 

(51:57 – 54:03)

Some women have postpartum depression, which is a very difficult situation and needs, in many cases, deserves clinical care. And the few women have postpartum psychosis, right? The fact that we now understand and accept and acknowledge that there’s a range of outcomes coming from this transition is what, number one, validates women’s experiences. So you don’t think you’re crazy and you can talk about things and ask for support.

 

Number two, enables screenings for these conditions. You, mother, go to the pediatrician. You have to fill out the depression test, right? Depressive questionnaire, which is very important.

 

And three, it allows for developmental drugs and medications that are targeted towards women who really need them at that point. There’s no such framework for menopause. Yes.

 

This is exactly where I wanted to get to. Yes. It’s like you’re in menopause.

 

That’s it. If you have hot flashes, we have the hormone therapy, but if you have burn fog, sorry, you’re on your own. And if hot flashes are really severe, I’ll give you exactly the same hormones that I’m going to give to somebody who has maybe one hot flash once in a while.

 

You can do that. We need to refine our strategies. We need to certainly refine the diagnosis.

 

We need to have biological markers to really understand how your brain is reacting to your menopause. And then we need to have informed conversations about all the options that are available. Some women don’t want hormones.

 

Some women can’t take hormones. Some women just want to have a healthy menopause, like you said. I mean, you’ll just go dance by the moon.

 

Some women want the hormones and can take them. And one thing is not exclusive of the other one, right? Hormones, but also exercise and eat healthily and practice sleep hygiene and do all these other things that may be helpful to you. And if you can’t take hormones, but you want, you would like a prescription medication to give you a little bit of a headstart and some relief.

 

(54:03 – 56:58)

There are some that are perfectly valuable and we can look at those instead. So in the book, I really just wanted to lay it all out. And we have half of the book is about what to do to feel better.

 

And just the whole chapter on hormone therapy, because it’s what everybody wants to talk to me about, but then non-hormonal medications. And then there’s a whole big section about lifestyle, everything we know about lifestyle adjustments for menopause. Brilliant.

 

So good. And so I have a question around the fact that you’ve said, can’t take hormones a couple of times, and it feels like we’re at a dawning of a new understanding of how many more people might actually find hormone therapy useful, beneficial, and completely safe that otherwise previously due to some research that was done in the end of the 20th century said, Oh my gosh, everybody has to stop HRT now. Where are we at in that research and understanding? We are in a much better place as of 2022 when professional societies released updated guidelines and they themselves said that the previous guidelines may actually have been harmful to some women because they were very restrictive.

 

And just to sum it up, it was more like, well, only take hormones if you really can’t do without and take the lowest possible dose for the shortest possible time. If that’s what your provider, if your doctor says to you, I think that it’s clearly not a strong incentive to try it. And that is absolutely the conversation people have been having with their doctors.

 

Yeah. For the past, well, since 2002, from 2000, which is the crash in the women’s health initiative to 2022 with the new guidance released in July. I remember that because I was writing the book, I was working on the book.

 

And when they came out, I was like, Oh, good timing. This comes out next year. Thank you.

 

I, I, I obviously follow the guidelines of professional societies and they go by the book, but I also am a scientist. I’m doing the research and sometimes it’s a little like, Ooh, I mean, I can tell that there’s enough research. It’d be more flexible.

 

How long is it going to take? Well, we, we know that science is often, you guys are far further ahead than the medical textbooks, which take a bit of time to catch up. Which is good because it’s more conservative and it’s safer, right? Research, research works in such a way that you may find something interesting and new, but then it really needs to be replicated multiple times before it can be considered reliable enough and generalizable enough that it can become a clinical recommendation. So it’s totally correct that there’s a gap.

 

(56:59 – 57:46)

As in his 20 years is a long time. But so these new guidelines are more flexible by far. And what they say is at least in the United States, but I think it’s the same.

 

No, it’s the same for us. Yes. So hormone therapy.

 

So a few differences from before that was still happens to be the same as the indications. So hormone therapy for menopause is approved for relief of hot flashes and night sweats, which are called basal motor symptoms. It is approved for prevention of osteoporosis and is approved for genital urinary symptoms like recurrent UTIs, urinary tract infections, and vaginal dryness, which can be really painful and also limit your sexual life.

 

(57:47 – 1:01:39)

So it’s more of an issue that we’ve been able to talk about for a really long time, right? These are three very important indications. Additionally, hormone therapy is often used off label for support of sleep disturbances during the session, especially if the sleep challenges are associated with hot flashes at night. So the night sweats and also for relief of mild depressive symptoms during period menopause and postmenopause, which is not the same as major depression, right? So different.

 

It’s also being evaluated. I hope for brain fog, which is one of the biggest concerns that most women this age. Yeah.

 

And when you say it’s, are we talking both progesterone and estrogen combined therapy, or are you talking about a specific hormone in that? No, it’s either estrogen with progesterone for women with uterus or estrogen alone for women who had the hysterectomy. Sometimes you can also take just progesterone, which may be helpful for sleep. It’s more helpful for sleep latency than for sleep maintenance, which means it helps you fall back asleep.

 

It doesn’t necessarily help you fall asleep, but it limits the amount of times that you wake up at night, which is awesome. I’m putting up my hand up to explore that. I have a little packet of progesterone in my cupboard waiting for day 14, as we speak, because I just think, you know, we, we, we shouldn’t, I just, I love where we arrived with what you shared there, because it feels like the invitation is to unite as women about the fact that we’ve been kept in the dark.

 

That is the unity message that we haven’t had the research that we haven’t had connection to elders to really understand the experience from our own families and from science. And so we should unite around that and say, you know, how is this for you? Oh my gosh, you put, you know, that sounds awful. And what I’m experiencing is this and all that must be really tough.

 

That’s not saying go take a medication. That’s just meeting people where we are at. And then someone else might be having a great time of it and actually doing fine.

 

And we go, how amazing for you, like brilliant. You know, when, when you’re pregnant, there’s baby showers, there’s petrostations, there’s support. Puberty is the same.

 

My parents even got me a gift. That’s so sweet. Yeah.

 

In Italy that happens. Yeah. You go through menopause and nobody wants to talk about it.

 

Most women share. Well, and nobody wants to talk to you. Certainly no celebration.

 

There’s no sense of achievement or a status gain. They’re just pride that you made it through like many years of challenges in a way. So I want to change that.

 

And they said to my husband, when I go through menopause, I do expect the party. Yeah, we did it, honey. I’m here.

 

Yeah. Why not? Why not? I think it’s a much more, I think it’s a beautiful thing to celebrate. It’s another face, the big face in a woman’s life.

 

It’s no longer reproductive, but you can’t, you’re probably going to be just as productive. Yeah. So that’s it, isn’t it? So just because someone is no longer reproductive doesn’t mean this becomes an unproductive stage of life.

 

(1:01:40 – 1:02:51)

Exactly. Like the, the stereotype of the post-menopausal woman wearing a shawl and baking pie. I mean, that’s what you like 100% we do, but most women are just, remain just vibrant, beautiful beings full of life.

 

And I think that having this negative idea of yourself as being less valuable, less attractive or less worth the attention because don’t have a menstrual cycle. I think that just makes no sense. Yeah.

 

Agree. And I, you know, I I’m drawn, I find to people like Andy McDowell, who’s that fabulous American actress who says, you know, she talks about, um, just feeling hotter and better than ever, because there’s just so much more behind the eyes. You’ve done so much more with your life.

 

You’re so fascinating. Uh, and as you say, if, if that is being that more stereotypical, uh, homemaker extraordinaire, who just manages to then make time for everybody’s kids and be that wise elder. And that is your sense of role in that phase.

 

(1:02:51 – 1:03:07)

Brilliant. If your sense of role is running a huge company, because you see things clearer than you’ve ever seen before and you don’t care about the details anymore, then brilliant. And it feels like it is a call to the true essence of feminism, which is.

 

(1:03:09 – 1:04:30)

Understanding, love yourself, be able to express yourself, but also being grateful to your body. I mean, our bodies go through so much as women, even just having a menstrual cycle every month is a huge undertaking metabolically, you know, and connectivity wise is a lot in your body. Okay.

 

Maybe carry the pregnancy or maybe multiple pregnancies. And now once again, we’re going through menopause and we, we outlive it where most female species do not. Most animals just die soon after the end of their fertility span.

 

Right. But we don’t stay here. So we may as well enjoy the ride, which is not dismissing or discounting the challenges that menopause can bring about and the increased risks down the line that I think really deserve a conversation about prevention.

 

We know so much more now about prevention and there are so many things that one can do to protect your heart, to protect your brain, to protect your bones. So that’s important to have that conversation, but not to worry about the risks. Rather, I think to feel like, okay, what are all the things that I can do? Yeah.

 

It’s an optimization invitation. Yes. I think it’s a healthier way to think about women’s health.

 

(1:04:30 – 1:05:02)

Yeah. And so when it comes to food, what, what is the research telling us that we should prioritize in this age and stage? Fiber, anti-oxidants and anti-inflammatory foods. Those have been quite consistently associated with a gentler menopause and less severe symptoms.

 

And I know that everybody’s on a diet, at least in the States, people feel strongly about their diets. It’s almost like it’s a religion. Yeah.

 

(1:05:02 – 1:08:01)

Yeah. But there’s one diet pattern that’s been linked more consistently with women’s health, with optimal women’s health. And that is the Mediterranean diet or a Mediterranean style diet that could be greenified.

 

You can do like Mediterranean diet so that you get all your antioxidants and your fiber and your anti-inflammatory nutrients. And it’s also sustainable. It’s flexible and it’s yummy.

 

Yeah. Well, coming from an Italian, you fly the flag for that naturally. And as a half Frenchie, I do too.

 

And there is obviously for musculoskeletal health, a conversation around protein and making sure that there’s a decent amount of protein in the diet. Would you say that that’s consistent as well? Oh, for sure. Lean protein and yeah.

 

Yeah. I mean, all the important nutrients need to be part of the diet. You want to have a balanced diet, but the nutrients that seem to be very helpful for brain health and ovarian health are antioxidants, fiber, and anti-inflammatory nutrients in the context of a balanced, healthy diet.

 

And those are a little bit harder to come by. That’s why I mentioned them. So antioxidants only come from plants, fiber only comes from plants.

 

And we all know that nobody eats enough plants. I mean, it’s not true. Well, we eat the wrong plants often.

 

We just eat toast and pasta and actually the plants should be the rainbow plants. Yeah. Yeah.

 

It should be like eat the rainbow and whatnot. But also it’s not true. I mean, many people eat enough plants, but on average as a country, I think maybe in Australia as well, we’re the same.

 

Yeah. 65% of our shopping trolley as a nation is ultra processed foods. Yes.

 

That’s here. And I think, yeah, the U S I think it’s 70. You only do you pick up the post.

 

Yeah. So, yeah. So.

 

Minimize processed foods for sure. And focus on whole foods. And this is already a great starting point.

 

And then when you’re looking at your whole foods, really try to make sure that there are enough, just enough to produce basically frozen. If fresh is difficult to come by and yeah, that’s a good fit. So berries, berries are wonderful for brain health and the variant health as well, because they’re rich in antioxidants and fiber all at once like wild blueberries.

 

You can get them frozen. I love what I have a half cup every day. I love wild blueberries.

 

I was prescribed them by my, my awesome doctor a few years ago. And it really, for me just makes it almost feels like, ah, I’ve hit my target, but it actually feels like medicine. It’s probably one of the foods that I feel that most from.

 

(1:08:02 – 1:13:10)

Yeah. It’s wonderful. So diet really important.

 

Exercise is important, especially cardiovascular activity because it supports, I mean, not especially, but we start with cardiovascular activity because you get the most bang for your buck where you really has a boosting effect on your brain. It also helps regulate body temperature. So they may help alleviate some of the half flashes and the night sweats and just provide more balance.

 

So it’s really helpful for brain fog and then training for, uh, well, obviously for metabolic activity and for muscle mass and bone density and then mind body techniques for sleep and stress support as well as flexibility. So I know that we’ve got our to-do list. Oh, there it is.

 

It’s that healthy lifestyle list again, coming back to haunt us the basics. Um, I think people almost get frustrated that the basics actually matter that much, because that is actually what people feel so disconnected from being able to achieve in so many cases. So I think the more we just keep bringing it back to the basics, it’s not necessarily going to be the magic supplement.

 

Um, but it will, you know, if, if we’re doing HRT and supplements and all the things, but we’re not focused on the basics, it won’t be a surprise that the things aren’t working as well as they should. Yeah. I, yeah, no, I agree.

 

I think it’s important to have a healthy life overall, healthy lifestyle, and then optimize and target specific concerns, but you need, you need to be consistent, I think with your, with your health. It really, you know, it really does. And it was something you said, which was the midlife is one of the biggest predictors of older life health.

 

Uh, then if that’s not a call to prioritize right now, I don’t know what is, can I ask you one last question about HRT? Because this comes up a lot. Um, and it is around how long one would do it for and what does the research talk to us about now since these guideline changes, you mentioned, um, as low as possible, as short as possible with the old conversation, but now could it be something that one just, it’s just a part of their daily routine indefinitely? I hear people who, there’s a friend of mine who always says I’m going to die with my patch on. Um, I love that.

 

That’s not Dr. Mary Claire, is it? Yes. I knew it. I could just hear her saying that.

 

I love it. She’s so fabulous. Um, now so far is, well, the good thing is that you don’t have to stop taking hormones just because you are any specific age.

 

So that has, if you, that’s been debunked. Okay. Yeah.

 

I mean, I wouldn’t say debunked, but yeah, it’s been changed. There’s no clear indicator as to why you would come off it if everything was fine. Yeah.

 

Yeah. And also for as long as you have the symptoms, people said, you know, if you have a benefit, then just stay on it. Um, yeah, there’s, there’s, the question is whether you want to start in older age and mixed messages out there.

 

I think I’m just going to follow the research and we know from the Women’s Health Initiative and other studies that the benefits of hormone therapy kind of wane over time. So the further away you are from your final menstrual period and the more the benefit risk ratio goes back towards the risks in a way. So we know that starting hormone therapy more than 10 years after the final menstrual period may increase, may either have no benefits or potentially increase a little bit the risk of heart disease, dementia, cancer, but we need more research on that because a lot of the data that we were still looking at.

 

It’s still evolving science, isn’t it? So I had coffee with a girlfriend who came through breast cancer a few years ago, and she was told black and white it’s because you were on HRT. It’s what do we now know about the implication of HRT in cancer? It’s not as black and white. One thing that I wanted to say is that if, however, if you have symptoms and you’re more than 10 years after postmenopausal, you can still start taking hormones.

 

(1:13:11 – 1:16:27)

So what we’re thinking right now is that for as long as you have hormones, it doesn’t matter how old you are because it’s your hormonal age that is giving you the hormones, not your chronological age. Very important. Yeah, it is important because some women are super flashers, and they keep having hot flashes for many, many years after the last menstrual period.

 

And if you’re like 55 years old and you have the hot flashes, then HRT is a valuable option. But so is if you’re 65 years old, perhaps if you’re older than that. And it’s really about checks and balances.

 

You want to test, you want to be clear about the pros and cons, and you want to know your own risks and then plan accordingly. Now, breast cancer, the risk of breast cancer with hormone therapy was certainly overemphasized by the media following the end of the Women’s Health Initiative. What professional societies are saying now is that the risk of breast cancer, the risk of occurrence of breast cancer for women who are within 10 years of the final menstrual period and never had breast cancer before is actually very small.

 

Breast cancer is considered a rare occurrence while taking hormones. Now, why is prevention important? Why is screening important? Because if you don’t get a mammogram, you don’t know if you have maybe a teeny tiny cancer, or maybe there’s pre-cancerous cells that you can detect with other techniques. And then if you take hormone therapy on top of that, they may increase the risk of the cancer growing.

 

It’s not that it magically makes the cancer appear. At least this is what people are saying. The current understanding.

 

Yeah. Yeah. I would love to see more research on that.

 

Yes. I think we all would. And I’ve heard weird things on social media that taking hormones may reduce the risk of breast cancer.

 

I haven’t seen any evidence of that. Thank you for clarifying, because I had seen that too. Right.

 

Yeah. Yes. It’s a wild time out there.

 

Yeah. But I think it speaks to Lisa, you mentioning a couple of times now why it is actually important to have that lag, however frustrating it is sometimes when you think, well, hold on, this really does make sense. And I really would like to act on that research that the checks and balances of science are where they are.

 

But when it comes to hormone therapy, I feel like, you know, a lot of people are just coming down on this trend. Let’s call it because it is a big new flourishing conversation. And saying, oh, we’re over medicalizing menopause.

 

But I would almost challenge that. And it’s like, well, a lot of these women are on anxiety medication, depression medication, whole bunch of medication. So it actually could be potentially if we’re actually addressing the reason they’re having such a difficult time with some support for hormonally, it could actually decrease the reliance on medication in a lot of women.

 

(1:16:27 – 1:18:36)

You know, listen, in the United States, only 4% of all women of period menopausal and post-menopausal age receive a prescription for hormone therapy. And it’s 8% that we include compounded hormones. So that’s clearly not over treating.

 

No. And what would the percentage be of the amount of women in midlife on mental health related prescriptions? About 30 to 40%, depending on the statistics. I saw 40% just the other day, but I think a more conservative estimate is 25, maybe 30%.

 

I feel a lot more. We are still looking at, you know, seven to eight times. Yes.

 

I mean, I think that menopause has was certainly over medicalized in the past when all women were put on hormones and before women were treated terribly for their menopause, but we’re looking at, you know, 19th century, early 20th century. But still today, you know, you end up taking a lot of prescription medications to deal with symptoms that are potentially hormonal. And why is that not an over medicalization? Wouldn’t it make more sense, like you were saying, to find out exactly what the problem is and then treat that problem? And I think that means more research, more testing, the right testing that really can answer those questions and technologies that allow us to really test more thoroughly the options that we have.

 

Yeah, a hundred percent. It’s a little bit dismaying that a lot of what they say is just that we don’t really have any data. But I’m hoping that now that menopause is going mainstream, you know, President Biden, Dr. Biden, his wife, really pushed to have a moonshot for when menopause and they just signed this major bill for twelve billion dollars to be allocated towards advancing research on women’s health, which includes aging and menopause.

 

(1:18:37 – 1:19:20)

It’s so valuable because the cost to society, to the women themselves, to Medicare costs where we have Medicare here. But yeah, the medical flow on effect costs of not looking after women and supporting them is huge. Wow.

 

Gosh. So can I ask one final question? What will you be considering on your journey into midlife and beyond? Well, so I am. What’s on your menu? What are you? I am premenopausal.

 

(1:19:20 – 1:19:30)

I have a regular menstrual cycle, so I’m preparing for my transition. And right now I’m really focused on lifestyle. I made a number of adjustments.

 

(1:19:30 – 1:20:11)

It’s been a few years already. My husband thinks I’m nuts. What’s your most nuts thing that he thinks is nuts? Decaf.

 

Oh, OK. He thinks that’s absolutely unbearable and unacceptable. He loves coffee and I’m serving decaf.

 

But also, you know, my sleep schedule, my sleep hygiene is really, really thorough. And I’m a very disciplined person. So I eat very healthily always.

 

And there’s no plastic in my kitchen. There’s no processed food in my house, for sure. Oh, we bought a Reformer Pilates because I really enjoy Pilates.

 

(1:20:12 – 1:21:05)

And I’m really into cardio as well. So I try to work out at least three to five times a week whenever I can. They think that he thinks I’m a little bit crazy, isn’t it? I’m really disciplined.

 

Like, I don’t have a cheat day. My lifestyle is almost always, you know, something that’s also interesting because I am very mindful around environmental toxins. I find that their impact on brain health was really underestimated for a very long time.

 

I had mold toxicity, so I have been at the front lines of that journey. My gosh. Yes.

 

And there was pollution and all the pesticides and the chemicals, the processed foods, but also skin care. Yeah. That’s what I teach.

 

Yeah. I’ve been using an Australian skincare line for 10 years. Oh, which one? I absolutely love it.

 

(1:21:05 – 1:21:09)

It’s organic certified. It’s called Cora with a K. Ah, yes. Gorgeous.

 

(1:21:10 – 1:22:03)

It’s fantastic. The purity of the ingredients is top of the chart. So as a scientist, I really appreciate it.

 

And all the antioxidants that are in the oils and the lotions. And I think it’s really important because, you know, whatever you put in your skin, a huge part of that up to, I think it’s 50 or 60 percent of whatever you put in your skin ends up being transfused in your bloodstream and that’s in your circulation. So it is important to be mindful of whatever you put on your body and 100 percent.

 

Yeah. And especially now that we know how many preservatives are hormone disruptive, either blocking or mimicking, mimicking, mimicking natural hormone signaling. And then if we’re having a neuro endocrine transition on top of that, then, yeah, it speaks to why we would absolutely want to make sure we were low tox.

 

(1:22:04 – 1:22:27)

What a beautiful way to bring it back to message. Love that. It has been such a joy exploring this topic with you, Lisa.

 

I think your work is brilliant. I would also like to nod to your first book, the XX Brain on the connection between outside a second. What was the first one? It’s called Brain Food.

 

(1:22:28 – 1:22:39)

Oh, OK. So I have to dig even deeper because I read both in preparation for chatting to you, but I didn’t know there was a third, which was your first. OK, brilliant.

 

(1:22:40 – 1:23:01)

One, two, three. Yeah. Yeah.

 

Your work is wonderful. It’s so calming and objective in a very tumultuous online conversation on health, which often I think confuses people. So thank you for your work.

 

And it’s just been such a joy to chat. Thank you. Thank you so much for having me.

 

(1:23:01 – 1:25:36)

I hope you loved today’s show as much as I loved bringing it to you. I want to remind you that if you are someone who craves a low tox community that is judgment free, full of empowerment, has health professionals and building health professionals that can support you as well as me in their answering questions multiple times a week, I want to invite you to join the low tox club for the price of less than a cup of coffee a month. You have an annual membership for forty nine dollars Australian.

 

So it’s about thirty dollars US or euro that allows you to have a member masterclass every single month with a health professional or global expert from the podcast where we have them to ourselves for an hour to ask questions and deep dive further. You have the beautiful supportive chat group. You have Q&A’s with me, me answering questions.

 

We read books and talk about them and a whole bunch more. You can head to low tox life dot com, hit the explore tab and join the club is the very first option on that list. Of course, we have over 10 evergreen courses that you can jump into any time, whether it’s navigating everyday low tox swaps with our go low tox signature course, whether you have kids and you’re wanting to know how to best support them with our low tox kids course, whether you’re planning a family and looking at a healthy low tox preconception journey, reducing inflammation, especially the chronic kind without inflammation ninja course, many, many other courses.

 

You can again head to low tox life dot com, hit the courses tab and you’ll see all of the options, which includes a business course, my low tox method program. A lot of people don’t know, but I was doing a lot before starting low tox life in 2009 and I was a business consultant across hospitality, health, retail and cosmetics. I have been in business consulting for a very long time, so I absolutely adore helping people move into the low tox space or develop their low tox businesses.

 

So that’s a way I can support you. And then of course, there’s our wonderful social media communities at low tox life on Instagram. And of course the website with over 250 gluten free recipes, blogs, downloadable PDFs to help you navigate wanting to get rid of synthetic fragrances in your school or office.

 

I could go on. So head to low tox life dot com, see what takes your interest or fancy. And thank you so much for being a part of our podcast community.

 

(1:25:36 – 1:25:57)

I love, love, love reading your reviews. I appreciate every follow and subscribe. And I want to just remind you to finish off that if there’s anything you heard that you found interesting from medical or scientific perspective, it is intended as education only.

 

Please always chat to a health professional who knows you and your situation best. I’ll see you next week. Bye.

 

 

 

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