Women are works of art.
00:13
On the outside as on the inside.
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I am a neuroscientist,
and I focus on the inside,
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especially on women's brains.
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There are many theories
on how women's brains differ
00:24
and I've been looking
at brains for 20 years
00:28
and can guarantee
that there is no such thing
00:30
as a gendered brain.
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Pink and blue, Barbie and Lego,
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those are all inventions
that have nothing to do
00:38
with the way our brains are built.
00:40
That said, women's brains
differ from men's brains
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And I'm here to talk
about these differences,
00:48
because they actually matter
for our health.
00:50
women are more likely than men
to be diagnosed with an anxiety disorder
00:55
not to mention headaches and migraines.
01:00
But also, at the core of my research,
01:03
women are more likely than men
to have Alzheimer's disease.
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Alzheimer's disease
is the most common cause
01:09
of dementia on the planet,
01:12
affecting close to six million people
in the United States alone.
01:14
But almost two thirds of all those people
01:19
are actually women.
01:23
So for every man
suffering from Alzheimer's
01:25
there are two women.
01:28
So why is that overall?
01:29
What else could it be?
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I launched the Women's Brain Initiative
01:39
at Weill Cornell Medicine
in New York City,
01:40
exactly to answer those questions.
01:43
And tonight, I'm here with some answers.
01:45
So it turns out
our brains age differently,
01:49
and menopause plays
a key role here for women.
01:54
Now most people think of the brain
as a kind of black box,
01:59
isolated from the rest of the body.
02:02
But in reality, our brains
are in constant interaction
02:04
with the rest of us.
02:07
And perhaps surprisingly,
02:08
the interactions
with the reproductive system
02:10
are crucial for brain aging in women.
02:14
These interactions
are mediated by our hormones.
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And we know that hormones differ
between the genders.
02:20
Men have more testosterone,
women have more estrogens.
02:24
But what really matters here
02:28
is that these hormones differ
in their longevity.
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Men's testosterone doesn't run out
until late in life,
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which is a slow and pretty much
symptom-free process, of course.
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Women's estrogens, on the other hand,
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start fading in midlife, during menopause,
02:47
which is anything but symptom-free.
02:50
We associate menopause with the ovaries,
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but when women say
that they're having hot flashes,
02:57
night sweats, insomnia,
memory lapses, depression, anxiety,
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those symptoms don't start in the ovaries.
03:03
They start in the brain.
03:06
Those are neurological symptoms.
03:08
We're just not used
to thinking about them as such.
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Why are our brains impacted by menopause?
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Well, first of all,
03:19
our brains and ovaries are part
of the neuroendocrine system.
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As part of the system,
the brain talks to the ovaries
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and the ovaries talk back to the brain,
03:27
every day of our lives as women.
03:29
So the health of the ovaries
is linked to the health of the brain.
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And the other way around.
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hormones like estrogen
are not only involved in reproduction,
03:39
but also in brain function.
03:43
And estrogen in particular, or estradiol,
03:46
is really key for energy
production in the brain.
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At the cellular level,
03:52
estrogen literally pushes neurons
to burn glucose to make energy.
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If your estrogen is high,
03:58
your brain energy is high.
03:59
When your estrogen declines though,
04:01
your neurons start slowing down
and age faster.
04:04
And studies have shown that this process
04:08
can even lead to the formation
of amyloid plaques,
04:10
or Alzheimer's plaques,
04:13
which are a hallmark
of Alzheimer's disease.
04:15
These effects are stronger
in specific brain regions,
04:18
starting with the hypothalamus,
04:21
which is in charge of regulating
body temperature.
04:23
When estrogen doesn't activate
the hypothalamus correctly,
04:26
the brain cannot regulate
body temperature correctly.
04:29
So those hot flashes that women get,
04:33
that's the hypothalamus.
04:35
Then there's the brain stem,
in charge of sleep and wake.
04:37
When estrogen doesn't activate
the brain stem correctly,
04:40
we have trouble sleeping.
04:43
Or it's the amygdala,
04:45
the emotional center of the brain,
close to the hippocampus,
04:46
the memory center of the brain.
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When estrogen levels ebb in these regions,
04:52
we start getting mood swings perhaps
04:55
So this is the brain anatomy
of menopause, if you will.
04:58
But let me show you
05:03
what an actual
woman's brain can look like.
05:04
So this is a kind of brain scan
05:07
called positron emission
tomography or PET.
05:09
It looks at brain energy levels.
05:11
And this is what you want
your brain to look like
05:13
when you're in your 40s.
05:17
Really nice and bright.
05:19
Now this brain belongs to a woman
who was 43 years old
05:21
when she was first scanned,
before menopause.
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And this is the same brain
just eight years later,
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If we put them side by side,
05:34
I think you can easily see
how the bright yellow
05:36
turned orange, almost purple.
05:39
That's a 30 percent drop
in brain energy levels.
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this just doesn't seem to happen
to a man of the same age.
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In our studies with hundreds of people,
05:54
we show that middle-aged men
usually have high brain energy levels.
05:57
For women, brain energy
is usually fine before menopause,
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but then it gradually declines
during the transition.
06:06
And this was found independent of age.
06:10
It didn't matter
if the women were 40, 50 or 60.
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What mattered most
was that they were in menopause.
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So of course we need
more research to confirm this,
06:21
but it looks like
women's brains in midlife
06:24
are more sensitive to hormonal aging
06:26
than just straight up chronological aging.
06:29
And this is important information to have,
06:32
because so many women
can feel these changes.
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So many of our patients have said to me
06:37
that they feel like their minds
are playing tricks on them,
06:39
So I really want to validate this,
because it's real.
06:44
And so just to clarify, if this is you,
06:47
So many women have worried
that they might be losing their minds.
07:00
But the truth is that your brain
might be going through a transition,
07:03
or is going through a transition
07:06
and needs time and support to adjust.
07:08
Also, if anyone is concerned
07:11
that middle-aged women
might be underperformers,
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I'll just quickly add
that we looked at cognitive performance,
07:16
But we looked at cognitive performance,
07:23
and we found absolutely no differences
between men and women
07:25
before and after menopause.
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And other studies confirm this.
07:31
So basically, we may be tired,
07:33
but we are just as sharp.
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Get that out of the way.
07:41
there is something else more serious
that deserves our attention.
07:44
I mentioned that estrogen declines
could potentially promote
07:49
the formation of amyloid plaques,
or Alzheimer's plaques.
07:51
But there's another kind of brain scan
that looks exactly at those plaques.
07:54
And we used it to show
that middle-aged men hardly have any,
07:58
there's quite a bit of an increase
during the transition to menopause.
08:05
And I want to be really, really clear here
08:10
that not all women develop the plaques,
08:12
and not all women with the plaques
develop dementia.
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Having the plaques is a risk factor,
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it is not in any way a diagnosis,
especially at this stage.
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But still, it's quite an insight
08:24
to associate Alzheimer's with menopause.
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We think of menopause
as belonging to middle age
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and Alzheimer's as belonging to old age.
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many studies, including my own work,
08:35
had shown that Alzheimer's disease
starts with negative changes in the brain
08:37
years, if not decades,
prior to clinical symptoms.
08:42
it looks like this process
starts in midlife,
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Which is important information to have,
08:52
because it gives us a time line
to start looking for those changes.
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So in terms of a time line,
08:58
most women go through menopause
in their early 50s.
09:00
But it can be earlier,
09:04
often because of medical interventions.
09:05
And the common example is a hysterectomy
and/or an oophorectomy,
09:08
which is the surgical
removal of the uterus
09:12
and/or the ovaries.
09:15
And unfortunately, there is evidence
09:17
that having the uterus
and, more so, the ovaries removed
09:19
correlates with the higher risk
of dementia in women.
09:24
And I know that this is upsetting news,
09:29
and it's definitely depressing news,
09:31
but we need to talk about it
09:33
because most women
are not aware of this correlation,
09:35
and it seems like very important
information to have.
09:38
Also, no one is suggesting
that women decline these procedures
09:42
The point here is that we really need
to better understand
09:46
what happens to our brains
as we go through menopause,
09:50
natural or medical,
09:54
and how to protect
our brains in the process.
09:55
So how do we do that?
09:59
How do we protect our brains?
10:00
Should we take hormones?
10:02
That's a fair question,
it's a good question.
10:03
And the shortest possible answer right now
10:06
is that hormonal therapy can be helpful
10:09
to alleviate a number of symptoms,
like hot flashes,
10:11
but it's not currently recommended
for dementia prevention.
10:15
And many of us are working
on testing different formulations
10:18
and different dosages
and different time lines,
10:22
and hopefully, all this work will lead
to a change in recommendations
10:24
Meanwhile, there are other things
that we can do today
10:30
to support our hormones
and their effects on the brain
10:34
that do not require medications
10:36
but do require taking a good look
at our lifestyle.
10:39
That's because the foods we eat,
10:42
how much exercise we get,
10:45
how much sleep we get or don't get,
10:46
how much stress we have in our lives,
10:49
those are all things that can actually
impact our hormones --
10:51
for better and for worse.
10:54
There are many diets out there,
10:58
but studies have shown
that the Mediterranean diet in particular
11:00
is supportive of women's health.
11:04
Women on this diet have a much lower risk
11:07
of cognitive decline, of depression,
11:11
of heart disease,
of stroke and of cancer,
11:13
and they also have fewer hot flashes.
11:16
What's interesting about this diet
11:19
is that it's quite rich in foods
that contain estrogens
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in the form of phytoestrogens
or estrogens from plants
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that act like mild estrogens
in our bodies.
11:29
Some phytoestrogens have been linked
to a possible risk of cancer,
11:32
but not the ones in this diet,
which are safe.
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Especially from flax seeds,
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sesame seeds, dried apricots,
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legumes and a number of fruits.
11:45
And for some good news,
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dark chocolate
contains phytoestrogens, too.
11:49
So diet is one way to gain estrogens,
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but it's just as important to avoid things
that suppress our estrogens instead,
11:56
Stress can literally steal your estrogens,
12:02
and that's because cortisol,
which is the main stress hormone,
12:05
works in balance with our estrogens.
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So if cortisol goes up,
your estrogens go down.
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If cortisol goes down,
your estrogens go back up.
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So reducing stress is really important.
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It doesn't just help your day,
12:19
it also helps your brain.
12:21
So these are just a few things
12:24
that we can do to support our brains
12:25
and there are more.
12:27
But the important thing here
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is that changing the way
we understand the female brain
12:30
really changes the way
that we care for it,
12:34
and the way that we frame women's health.
12:37
And the more women
demand this information,
12:39
the sooner we'll be able to break
the taboos around menopause,
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and also come up with solutions
that actually work,
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not just for Alzheimer's disease,
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but for women's brain health as a whole.
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Brain health is women's health.
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