How menopause affects the brain
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0:01 - 0:04Women are works of art.
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0:04 - 0:06On the outside as on the inside.
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0:06 - 0:10I am a neuroscientist,
and I focus on the inside, -
0:10 - 0:12especially on women's brains.
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0:12 - 0:15There are many theories
on how women's brains differ -
0:15 - 0:17from men's brains,
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0:17 - 0:19and I've been looking
at brains for 20 years -
0:19 - 0:22and can guarantee
that there is no such thing -
0:22 - 0:24as a gendered brain.
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0:24 - 0:26Pink and blue, Barbie and Lego,
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0:26 - 0:29those are all inventions
that have nothing to do -
0:29 - 0:31with the way our brains are built.
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0:32 - 0:35That said, women's brains
differ from men's brains -
0:35 - 0:37in some respects.
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0:37 - 0:39And I'm here to talk
about these differences, -
0:39 - 0:42because they actually matter
for our health. -
0:42 - 0:44For example,
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0:44 - 0:47women are more likely than men
to be diagnosed with an anxiety disorder -
0:47 - 0:49or depression,
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0:49 - 0:51not to mention headaches and migraines.
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0:52 - 0:54But also, at the core of my research,
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0:54 - 0:58women are more likely than men
to have Alzheimer's disease. -
0:58 - 1:00Alzheimer's disease
is the most common cause -
1:00 - 1:02of dementia on the planet,
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1:02 - 1:08affecting close to six million people
in the United States alone. -
1:08 - 1:11But almost two thirds of all those people
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1:11 - 1:13are actually women.
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1:13 - 1:16So for every man
suffering from Alzheimer's -
1:16 - 1:18there are two women.
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1:18 - 1:21So why is that overall?
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1:21 - 1:22Is it age?
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1:22 - 1:23Is it lifespan?
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1:23 - 1:26What else could it be?
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1:26 - 1:27A few years ago,
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1:27 - 1:29I launched the Women's Brain Initiative
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1:29 - 1:31at Weill Cornell Medicine
in New York City, -
1:31 - 1:34exactly to answer those questions.
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1:34 - 1:37And tonight, I'm here with some answers.
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1:38 - 1:42So it turns out
our brains age differently, -
1:42 - 1:46and menopause plays
a key role here for women. -
1:47 - 1:50Now most people think of the brain
as a kind of black box, -
1:50 - 1:52isolated from the rest of the body.
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1:52 - 1:56But in reality, our brains
are in constant interaction -
1:56 - 1:57with the rest of us.
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1:57 - 1:58And perhaps surprisingly,
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1:58 - 2:02the interactions
with the reproductive system -
2:02 - 2:06are crucial for brain aging in women.
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2:06 - 2:09These interactions
are mediated by our hormones. -
2:09 - 2:13And we know that hormones differ
between the genders. -
2:13 - 2:16Men have more testosterone,
women have more estrogens. -
2:16 - 2:18But what really matters here
-
2:18 - 2:21is that these hormones differ
in their longevity. -
2:21 - 2:25Men's testosterone doesn't run out
until late in life, -
2:25 - 2:29which is a slow and pretty much
symptom-free process, of course. -
2:30 - 2:33(Laughter)
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2:33 - 2:35Women's estrogens, on the other hand,
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2:35 - 2:38start fading in midlife, during menopause,
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2:38 - 2:42which is anything but symptom-free.
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2:42 - 2:45We associate menopause with the ovaries,
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2:45 - 2:48but when women say
that they're having hot flashes, -
2:48 - 2:52night sweats, insomnia,
memory lapses, depression, anxiety, -
2:52 - 2:54those symptoms don't start in the ovaries.
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2:54 - 2:57They start in the brain.
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2:57 - 2:59Those are neurological symptoms.
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2:59 - 3:02We're just not used
to thinking about them as such. -
3:02 - 3:04So why is that?
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3:04 - 3:07Why are our brains impacted by menopause?
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3:07 - 3:09Well, first of all,
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3:09 - 3:13our brains and ovaries are part
of the neuroendocrine system. -
3:13 - 3:15As part of the system,
the brain talks to the ovaries -
3:15 - 3:17and the ovaries talk back to the brain,
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3:17 - 3:20every day of our lives as women.
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3:20 - 3:24So the health of the ovaries
is linked to the health of the brain. -
3:24 - 3:26And the other way around.
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3:26 - 3:28At the same time,
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3:28 - 3:31hormones like estrogen
are not only involved in reproduction, -
3:31 - 3:34but also in brain function.
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3:34 - 3:37And estrogen in particular, or estradiol,
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3:37 - 3:41is really key for energy
production in the brain. -
3:41 - 3:42At the cellular level,
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3:42 - 3:46estrogen literally pushes neurons
to burn glucose to make energy. -
3:46 - 3:48If your estrogen is high,
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3:48 - 3:50your brain energy is high.
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3:50 - 3:52When your estrogen declines though,
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3:52 - 3:56your neurons start slowing down
and age faster. -
3:56 - 3:58And studies have shown that this process
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3:58 - 4:02can even lead to the formation
of amyloid plaques, -
4:02 - 4:03or Alzheimer's plaques,
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4:03 - 4:06which are a hallmark
of Alzheimer's disease. -
4:06 - 4:09These effects are stronger
in specific brain regions, -
4:09 - 4:11starting with the hypothalamus,
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4:11 - 4:14which is in charge of regulating
body temperature. -
4:14 - 4:17When estrogen doesn't activate
the hypothalamus correctly, -
4:17 - 4:21the brain cannot regulate
body temperature correctly. -
4:21 - 4:23So those hot flashes that women get,
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4:23 - 4:26that's the hypothalamus.
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4:26 - 4:29Then there's the brain stem,
in charge of sleep and wake. -
4:29 - 4:32When estrogen doesn't activate
the brain stem correctly, -
4:32 - 4:34we have trouble sleeping.
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4:34 - 4:35Or it's the amygdala,
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4:35 - 4:38the emotional center of the brain,
close to the hippocampus, -
4:38 - 4:40the memory center of the brain.
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4:40 - 4:43When estrogen levels ebb in these regions,
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4:43 - 4:45we start getting mood swings perhaps
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4:45 - 4:47and forget things.
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4:47 - 4:51So this is the brain anatomy
of menopause, if you will. -
4:51 - 4:52But let me show you
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4:52 - 4:55what an actual
woman's brain can look like. -
4:55 - 4:57So this is a kind of brain scan
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4:57 - 5:00called positron emission
tomography or PET. -
5:00 - 5:02It looks at brain energy levels.
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5:02 - 5:06And this is what you want
your brain to look like -
5:06 - 5:07when you're in your 40s.
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5:07 - 5:09Really nice and bright.
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5:09 - 5:12Now this brain belongs to a woman
who was 43 years old -
5:12 - 5:16when she was first scanned,
before menopause. -
5:16 - 5:20And this is the same brain
just eight years later, -
5:20 - 5:23after menopause.
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5:23 - 5:25If we put them side by side,
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5:25 - 5:27I think you can easily see
how the bright yellow -
5:27 - 5:30turned orange, almost purple.
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5:30 - 5:34That's a 30 percent drop
in brain energy levels. -
5:35 - 5:37Now in general,
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5:37 - 5:43this just doesn't seem to happen
to a man of the same age. -
5:43 - 5:45In our studies with hundreds of people,
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5:45 - 5:50we show that middle-aged men
usually have high brain energy levels. -
5:50 - 5:54For women, brain energy
is usually fine before menopause, -
5:54 - 5:58but then it gradually declines
during the transition. -
5:59 - 6:02And this was found independent of age.
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6:02 - 6:05It didn't matter
if the women were 40, 50 or 60. -
6:05 - 6:09What mattered most
was that they were in menopause. -
6:09 - 6:12So of course we need
more research to confirm this, -
6:12 - 6:15but it looks like
women's brains in midlife -
6:15 - 6:17are more sensitive to hormonal aging
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6:17 - 6:20than just straight up chronological aging.
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6:20 - 6:22And this is important information to have,
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6:22 - 6:26because so many women
can feel these changes. -
6:26 - 6:28So many of our patients have said to me
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6:28 - 6:31that they feel like their minds
are playing tricks on them, -
6:31 - 6:32to put it mildly.
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6:32 - 6:35So I really want to validate this,
because it's real. -
6:35 - 6:39And so just to clarify, if this is you,
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6:39 - 6:41you are not crazy.
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6:41 - 6:43(Laughter)
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6:43 - 6:45(Applause)
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6:45 - 6:46Thank you.
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6:47 - 6:48It's important.
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6:48 - 6:51So many women have worried
that they might be losing their minds. -
6:51 - 6:55But the truth is that your brain
might be going through a transition, -
6:55 - 6:56or is going through a transition
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6:56 - 6:59and needs time and support to adjust.
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6:59 - 7:01Also, if anyone is concerned
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7:01 - 7:04that middle-aged women
might be underperformers, -
7:04 - 7:07I'll just quickly add
that we looked at cognitive performance, -
7:07 - 7:08God forbid, right?
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7:08 - 7:10(Laughter)
-
7:10 - 7:12Let's not do that.
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7:12 - 7:14But we looked at cognitive performance,
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7:14 - 7:17and we found absolutely no differences
between men and women -
7:17 - 7:20before and after menopause.
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7:20 - 7:22And other studies confirm this.
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7:22 - 7:25So basically, we may be tired,
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7:25 - 7:27but we are just as sharp.
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7:27 - 7:29(Laughter)
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7:29 - 7:31Get that out of the way.
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7:31 - 7:33That all said,
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7:33 - 7:36there is something else more serious
that deserves our attention. -
7:36 - 7:37If you remember,
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7:37 - 7:40I mentioned that estrogen declines
could potentially promote -
7:40 - 7:43the formation of amyloid plaques,
or Alzheimer's plaques. -
7:43 - 7:46But there's another kind of brain scan
that looks exactly at those plaques. -
7:46 - 7:50And we used it to show
that middle-aged men hardly have any, -
7:50 - 7:52which is great.
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7:52 - 7:53But for women,
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7:53 - 7:58there's quite a bit of an increase
during the transition to menopause. -
7:58 - 8:00And I want to be really, really clear here
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8:00 - 8:03that not all women develop the plaques,
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8:03 - 8:06and not all women with the plaques
develop dementia. -
8:06 - 8:08Having the plaques is a risk factor,
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8:08 - 8:12it is not in any way a diagnosis,
especially at this stage. -
8:12 - 8:15But still, it's quite an insight
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8:15 - 8:17to associate Alzheimer's with menopause.
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8:17 - 8:20We think of menopause
as belonging to middle age -
8:20 - 8:23and Alzheimer's as belonging to old age.
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8:23 - 8:24But in reality,
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8:24 - 8:26many studies, including my own work,
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8:26 - 8:30had shown that Alzheimer's disease
starts with negative changes in the brain -
8:30 - 8:35years, if not decades,
prior to clinical symptoms. -
8:35 - 8:36So for women,
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8:36 - 8:39it looks like this process
starts in midlife, -
8:39 - 8:40during menopause.
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8:40 - 8:42Which is important information to have,
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8:42 - 8:47because it gives us a time line
to start looking for those changes. -
8:47 - 8:49So in terms of a time line,
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8:49 - 8:52most women go through menopause
in their early 50s. -
8:52 - 8:54But it can be earlier,
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8:54 - 8:57often because of medical interventions.
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8:57 - 9:01And the common example is a hysterectomy
and/or an oophorectomy, -
9:01 - 9:03which is the surgical
removal of the uterus -
9:03 - 9:05and/or the ovaries.
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9:05 - 9:08And unfortunately, there is evidence
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9:08 - 9:11that having the uterus
and, more so, the ovaries removed -
9:11 - 9:13prior to menopause
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9:13 - 9:17correlates with the higher risk
of dementia in women. -
9:17 - 9:20And I know that this is upsetting news,
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9:20 - 9:22and it's definitely depressing news,
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9:22 - 9:23but we need to talk about it
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9:23 - 9:27because most women
are not aware of this correlation, -
9:27 - 9:30and it seems like very important
information to have. -
9:30 - 9:33Also, no one is suggesting
that women decline these procedures -
9:33 - 9:35if they need them.
-
9:35 - 9:39The point here is that we really need
to better understand -
9:39 - 9:42what happens to our brains
as we go through menopause, -
9:42 - 9:44natural or medical,
-
9:44 - 9:47and how to protect
our brains in the process. -
9:47 - 9:49So how do we do that?
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9:49 - 9:50How do we protect our brains?
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9:50 - 9:52Should we take hormones?
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9:52 - 9:55That's a fair question,
it's a good question. -
9:55 - 9:57And the shortest possible answer right now
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9:57 - 10:00is that hormonal therapy can be helpful
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10:00 - 10:03to alleviate a number of symptoms,
like hot flashes, -
10:03 - 10:07but it's not currently recommended
for dementia prevention. -
10:07 - 10:10And many of us are working
on testing different formulations -
10:10 - 10:13and different dosages
and different time lines, -
10:13 - 10:17and hopefully, all this work will lead
to a change in recommendations -
10:17 - 10:19in the future.
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10:19 - 10:22Meanwhile, there are other things
that we can do today -
10:22 - 10:25to support our hormones
and their effects on the brain -
10:25 - 10:27that do not require medications
-
10:27 - 10:31but do require taking a good look
at our lifestyle. -
10:31 - 10:33That's because the foods we eat,
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10:33 - 10:35how much exercise we get,
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10:35 - 10:37how much sleep we get or don't get,
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10:37 - 10:39how much stress we have in our lives,
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10:39 - 10:42those are all things that can actually
impact our hormones -- -
10:42 - 10:45for better and for worse.
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10:45 - 10:47Food, for example.
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10:47 - 10:49There are many diets out there,
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10:49 - 10:52but studies have shown
that the Mediterranean diet in particular -
10:52 - 10:56is supportive of women's health.
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10:56 - 10:59Women on this diet have a much lower risk
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10:59 - 11:02of cognitive decline, of depression,
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11:02 - 11:05of heart disease,
of stroke and of cancer, -
11:05 - 11:08and they also have fewer hot flashes.
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11:08 - 11:10What's interesting about this diet
-
11:10 - 11:14is that it's quite rich in foods
that contain estrogens -
11:14 - 11:18in the form of phytoestrogens
or estrogens from plants -
11:18 - 11:21that act like mild estrogens
in our bodies. -
11:21 - 11:24Some phytoestrogens have been linked
to a possible risk of cancer, -
11:24 - 11:27but not the ones in this diet,
which are safe. -
11:27 - 11:30Especially from flax seeds,
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11:30 - 11:33sesame seeds, dried apricots,
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11:33 - 11:36legumes and a number of fruits.
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11:36 - 11:37And for some good news,
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11:38 - 11:42dark chocolate
contains phytoestrogens, too. -
11:42 - 11:44So diet is one way to gain estrogens,
-
11:44 - 11:48but it's just as important to avoid things
that suppress our estrogens instead, -
11:48 - 11:50especially stress.
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11:50 - 11:53Stress can literally steal your estrogens,
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11:53 - 11:57and that's because cortisol,
which is the main stress hormone, -
11:57 - 11:59works in balance with our estrogens.
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11:59 - 12:02So if cortisol goes up,
your estrogens go down. -
12:02 - 12:05If cortisol goes down,
your estrogens go back up. -
12:05 - 12:07So reducing stress is really important.
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12:07 - 12:10It doesn't just help your day,
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12:10 - 12:12it also helps your brain.
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12:12 - 12:14So these are just a few things
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12:14 - 12:16that we can do to support our brains
-
12:16 - 12:17and there are more.
-
12:17 - 12:18But the important thing here
-
12:18 - 12:22is that changing the way
we understand the female brain -
12:22 - 12:25really changes the way
that we care for it, -
12:25 - 12:28and the way that we frame women's health.
-
12:28 - 12:31And the more women
demand this information, -
12:31 - 12:34the sooner we'll be able to break
the taboos around menopause, -
12:34 - 12:37and also come up with solutions
that actually work, -
12:37 - 12:39not just for Alzheimer's disease,
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12:39 - 12:42but for women's brain health as a whole.
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12:42 - 12:44Brain health is women's health.
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12:44 - 12:46Thank you.
-
12:46 - 12:48(Applause)
-
12:48 - 12:49Thank you.
-
12:49 - 12:50Oh, thank you.
- Title:
- How menopause affects the brain
- Speaker:
- Lisa Mosconi
- Description:
-
Many of the symptoms of menopause -- hot flashes, night sweats, insomnia, memory lapses, depression and anxiety -- start in the brain. How exactly does menopause impact cognitive health? Sharing groundbreaking findings from her research, neuroscientist Lisa Mosconi reveals how decreasing hormonal levels affect brain aging -- and shares simple lifestyle changes you can make to support lifelong brain health.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 13:04
Oliver Friedman edited English subtitles for How menopause affects the brain | ||
Oliver Friedman edited English subtitles for How menopause affects the brain | ||
Oliver Friedman edited English subtitles for How menopause affects the brain | ||
Erin Gregory approved English subtitles for How menopause affects the brain | ||
Erin Gregory edited English subtitles for How menopause affects the brain | ||
Erin Gregory edited English subtitles for How menopause affects the brain | ||
Joanna Pietrulewicz accepted English subtitles for How menopause affects the brain | ||
Joanna Pietrulewicz edited English subtitles for How menopause affects the brain |