The director of the Women’s Brain Initiative at Weill Cornell Medical College in New York and author of The XX Brain sat down with us to discuss the importance of women’s whole health.

By Health Magazine
April 08, 2020
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Allison Hooban / Courtesy of Mosconi

Can you explain what “bikini medicine” is for our readers?

Women have been chronically understudied in science and medicine; we have entire bodies of medical research that just do not include women. Historically, women have been considered to be like men with different reproductive organs, the only difference being the parts of the body that are covered by a bikini. Doctors and scientists would diagnose and treat both genders the same exact way as long as the reproductive organs were not the focus of the research. Women’s brains are not the same as men’s brains, but the vast majority of research is done in men.

How do male and female brains differ?

The most important difference is that men’s brains and women’s brains age differently. Testosterone and estrogen are like super-hormones; they serve a number of functions in the brain. Estrogen for women is really neuro-protective; it boosts the brain’s energy levels, which supports the immune system, and it keeps the brain young. Testosterone does the same for men. The difference is those hormones have a different life span. Testosterone declines fairly gradually with age and doesn’t fade away until very late in life, while for women, estrogen declines pretty fast in midlife due to menopause. The hormonal changes linked to menopause have a strong effect on women’s brains, potentially triggering anxiety or depression, or even increasing the risk of Alzheimer’s.

Is this why Alzheimer’s is so much more common in women?

Partly. Women are much more likely than men to end up being the caregiver for somebody with dementia, and we know caregivers of Alzheimer’s patients, because of stress, have a higher risk of developing dementia themselves. So we are really under attack from two different sides: We have our own risks of Alzheimer’s, and then our role in society also puts us at a bit of a disadvantage, if you will.

How does stress harm our brains?

Stress can literally steal hormones. Cortisol, which is the main stress hormone, works in balance with your estrogen. So if your cortisol goes up because you’re stressed, your estrogen production goes down. If your cortisol goes down because you’re reducing stress, then your estrogen levels go back up. That’s really important not just for your hormonal health but also really for brain health.

Knowing this information, how can women better advocate for themselves?

One of the reasons I wrote the book The XX Brain is that if you don’t know your risks, you’re not going to ask the right questions. We have shown men and women follow different pathways toward dementia. For men, it’s more related to heart disease and cardiovascular health, whereas for women, it seems to be more related to hormones and metabolic activity. Women may want to ask their doctors about thyroid function, about menopause. Am I estrogen-deficient, and can that impact my brain? Should I take hormones? These are all things we should really start thinking about and ask our doctors.

This article originally appeared in the May 2020 issue of Health Magazine. Click here to subscribe today!

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