- [Voice Over] Welcome to

XXplored, Women's Brain Health,

a dementia researcher podcast

exploring the many factors

that shape women's brain

health across the lifespan.

(upbeat music)

- Hello and welcome to another episode

of XXplored, Women's Brain Health.

Today we're diving into very important,

yet often misunderstood

reproductive stage in women's life,

which is the midlife transition,

also known as the menopause.

(upbeat music)

I'm your host Dr. Laura Stankeviciute

and today we are talking about menopause.

In the world, over one billion women

are going through this stage

or are already post-menopausal,

and this number is expected to rise

up to 1.2 billion in five years time.

There was a recent study

conducted in the UK

which found that nearly one

in four women aged 40 to 60,

covering this post-menopausal

and per menopausal period

that are considering

to quit the work due to

the menopausal symptoms

and there 14% of those who

are actually considering

to do so if not have done yet.

So women make up nearly half

of the global workforce population

and many will spend a huge amount

of time in the post reductive years.

Yet our research, support systems

and clinical care still remains patchy,

but perhaps it's not all that grey.

And in the past years indeed,

we have seen a huge

proliferation and a boom

towards the topic of

menopause, both in research

but also in the in the societal campaigns

such as Let's Talk About Menopause

to global celebrities

sharing their navigation

through this difficult and

sometimes daunting period.

But menopause is still only

framed around the topics

of vasomotor symptoms such as hot flashes

or night sweats, hormonal therapy,

or also sometimes mentioned

as the reproductive

ageing, while the brain

is still left out of the picture.

That's why today's episode will explore

how menopause might act not merely

as an endocrine transition,

but rather an neuroendocrine tipping point

and will help us understand

through this conversation

and move menopause from the sidelines

into the scientific

and societal spotlight.

And I'm joined today by

two great researchers

in this field of women's brain health,

but also specifically working

on the menopause transition.

So they're gonna help and

unpack these questions.

So it's my honour to

introduce Dr. Claudia Barth

who holds a professorship

for the neurobiology

of hormonal transitions at the Department

of Psychiatry in neurosciences

and the research unit gender in medicine,

university of Berlin in Germany.

She's a biologist

and also neuroscientist by training

with a strong background

in neuroendocrinology.

And another speaker of today,

our guest in the series

is Dr. Gillian Coughlan.

She's a junior researcher faculty

at Harvard Medical School MGH.

And her research projects

focus on elucidated

personalised risk factors

associated with the changes

in Alzheimer's disease biomarkers,

but also she's extremely

interested in understanding

how factors such as sex differences

may shape different trajectories

in AD pathophysiology

and cognitive decline, so welcome.

- Thank you very much for the invitation.

- Very happy to be here.

- Thank you for that introduction Laura.

That was great.

(upbeat music)

- So just before we diving

into our main themes of today,

I would like to ask just

a very simple question.

Can you tell in a few sentences

what are you actually doing?

'Cause obviously your

biographies are so, so rich,

but if you can distil

it very, very shortly

for our listeners, Claudia,

maybe you can go first.

You've been thinking for

some time, you want go first.

- So my research kind of as the title

of the professor where I was lucky

just got two months ago, kind of covers it

really how hormonal transition

periods impact the brain

with relevance to health and disease.

We broadly focus on depression

and Alzheimer's disease risk,

but thereby we focus on

diverse hormonal transitions

if it's just menstrual cycle

but also pregnancy and menopause.

In the last years,

the focus has been very much

shifted towards menopause

and perimenopause specifically.

I recently got a grant from

the European Research Council

to really tap into what's happening

during perimenopause transition.

So that's what I am doing

as I just started in my new

position like two months ago.

What I'm actually doing right

now is setting up a big study.

- Congratulations,

This is amazing and thank you so much

for doing the work

that you're doing

specifically in this area

that we know have been historically

really difficult to get funding.

So kudos definitely for this huge grant.

- Thank you very much.

- Yeah, so hi, so I'm Gillian Coughlan,

I'm junior research faculty

at Harvard Medical School

and I'm part of a grant

that kind of sets me up

to start off a lab the

start of 2026 actually.

So pretty soon, I'm mostly interested

in preclinical Alzheimer's disease

and I look specifically at,

you know, sex differences

in order to understand disease processes,

you know, kind of to a greater degree.

So coming at it for more of this

kind of personalised medicine approach

and then to understand why women

are disproportionately affected

by Alzheimer's disease,

I also look at things

like age at menopause,

specifically premature and early menopause

and the use of hormone therapy.

And I kind of investigate

how those two things are

associated with AD biomarkers,

primarily amyloid and tau pet,

but also plasma biomarkers

like 217, et cetera.

So we have a number

of different grants now both from the NIH

and different kind of foundation entities

as well as private funding

to look at women's brain health

and how it can potentially increase risk

for Alzheimer's disease in

that post-menopausal stage.

So I think at the moment,

there's actually so much interest

it seems on a global level in

terms of women's brain health

and Alzheimer's disease risk

and there's a lot of research being done

but I'm sure as we'll

discuss today, there's a lot

of research that we can also do I think

over the next three to five years.

- Well this is a very

rich portfolio of topics

that you are covering.

Jillian, I think there's so many research

that's gonna come up in the upcoming years

from both of your labs and

congratulations to both of you.

- Thank you.

(upbeat music)

So to start, I would like to go actually

into the very, very basics

of the question of what

is actually menopause.

'Cause sometimes I feel like

it's a very confusing topic

in terms of its terminology

because you know, sometimes we may think

or we can hear menopause being described

as this one point in

women's reproductive life

when a woman hasn't had

her menstrual period

for 12 consecutive months.

But of course that's more

of an oversimplification than the reality

because rather it's not just one point

but a culmination of biological changes

that have been preceding over the years.

So Claudia, could you clarify to us

what menopause really is?

And then obviously you

have mentioned already

the terminology of perimenopause,

so can you also touch

upon that and let us

clarify these two concepts.

- Of course.

- You kind of already hinted towards this.

So it's kind of actually a lengthy

endocrine transition period which starts

with the like progressive

failure of ovarian function.

So I like to compare it like,

or I always like to say to students,

so adolescence is when the

hormonal systems go online

after they went already went online once

during foetal development and mini purity.

But then menopause is

kind of the delayed stage

where systems slowly go offline.

But it's not that you turn a switch

and everything is offline

and you stop having cycles.

The system goes slightly offline

because it's regulated via the HPG axis.

I hope I don't mix up the German

and the English observation,

but basically the brain

regulates the ovaries

and this kind of little

dance gets interrupted

more and more and more, which leads

to erratic hormonal fluctuations,

which then eventually cease.

And that's the end of the

menopausal transition.

And as you nicely said,

menopause by definition

is actually just one time point

after you haven't had a

menstrual cycle for 12 months.

But preceding that, that's

what we call perimenopause,

which are years of increasing like levels

of fluctuation.

Normally in the early

perimenopausal stages,

you get slightly more variations

in menstrual cycle length,

tentatively more towards shorter cycles.

You don't really have symptoms yet

but your menstrual cycle length varies

and there's some hormonal markers

which slightly start changing.

Then in the late per menopausal stage,

which tends to on average we

between one to three years,

but they're varying accounts

when it comes to the

actual length of that,

that's where the cycle variations

become a much more

pronounced, late perimenopause

after the straw criteria

are defined by like not having

a cycle for 60 plus days.

And then that's when also symptoms

start to emerge in the majority of women.

And that can be sleep

disturbances, night sweats,

hot flashes, but also

cognitive disturbances

and depressive symptoms.

And then menopause again, this is one day

and then post menopause is kind of starts

after one year of not having had

a menstrual cycle for 12 months.

So actually there's one point

of menopause which is often used

to name the whole transition

is really assessed retrospectively

when you can say, okay, no,

after now I haven't had

a cycle for 12 months.

But also again for a lot of women,

this might not be textbook,

like they might not have a cycle

for one year but then it comes back.

So this system kind of

trying to compensate,

just having another cycle

and eventually it stops

and then hormonal fluctuation

stabilise and are stably low.

- Well I hope our listeners can appreciate

just how complex this whole continuum

of pre, peri and post menopause is.

And obviously each stage is accompanied

by different symptoms

and you mentioned obviously

the vasomotor symptoms,

which are those that are

related to hot flashes,

night sweats, but also you didn't leave

outside these cognitive symptoms

that sometimes kind of

are pushed under the rug.

And I would actually like to go

a little bit into those ones.

So what is the actual

neurobiological explanation

behind those symptoms?

'Cause obviously it varies.

We have different centres in the brain

that orchestrate different functions.

So we have the hypothalamus

perhaps more related

to this thermo regulation.

So vasomotor symptoms.

But what about these cognitive symptoms.

And also we hear that a lot of women

are experiencing really huge differences

in their mood from what they used to be

to how their mood or like even

their personality changes.

So what do we know about that Claudia,

in terms of the brain specifics?

- Well we know the most, you

already kind of hinted at,

is like the changes in firm of regulation

due to kind of changes

in the hypothalamus.

So that's also the most studied symptoms,

when it comes to the cognitive symptoms

and the repressive symptoms,

we don't know that much yet.

We know that declining

and especially volatility

like this volatile

decline in oestrogen,

it's not just like linearly declining.

It's like really fluctuating erratically

and oestrogen has multiple

functions in the brain

but it's also a very potent modulator

of neurotransmitter systems

which are very important

for your mood but also

your cognitive function.

So that would be one potential mechanism

which could like explain disturbances.

Then also this oestrogen

is neuroprotective

and with its declining level

this like neuroprotection

might be lifted and in some women,

which then also can contribute

to more accelerated ageing

but also kind of neurological decline

due to structural changes,

mainly from animal work

but also for some human studies.

And I think Gillian might

say more about that later,

but there are hint

stories like grey matter,

white matter changes,

Print was the first ones postulating.

There might be this

bioenergetic shift in the brain

that kind of what the brain uses

as an energy source might shift.

And because glucose metabolism changes,

then there's this theory

that away from glucose metabolism,

it shifts to ketone body,

like metabolising ketone bodies

which are part of the white matter.

And so it's like it's

a very complex system

which is likely very tightly interlinked.

And then any of these

changes might then contribute

to mood disturbance

and cognitive changes,

especially if you already

are potentially genetically

at risk if you have a certain lifestyle.

So which might not provide resilience

against these shifts

and especially also when you already

have a history of depressive disorders.

Depression has been postulated

as a very well established risk factor

of Alzheimer's disease later in life.

So it's very much tightly connected.

But my main statement in this regard

would be really structural changes,

functional changes

and particularly also changes

in neurotransmitter functioning.

- Wow, so all of these changes obviously

expose that women's brain

to be more vulnerable

to later life conditions and

neurodegenerative diseases

because of these fluctuations in hormones

that you mentioned and obviously

the critical glucose

consumption hypothesis

that has been presented by Brenton.

So now I'd like to shift the microphone

and give the floor to Gillian

because I would like

to talk about probably the

research area that we work in

and the research area

that has been receiving

so much interest in the

greatest scheme of menopause,

which is Alzheimer's disease.

So obviously we know that

women make roughly 2/3

of all Alzheimer's disease cases,

but obviously it's not just the longevity

that explains all of

these staggering numbers,

but it's actually the underlying biology

and the also cognitive

trajectories that we see in women.

And in the past decades we

have had this hypothesis

of menopause really breaching through

and suggesting that this

is due to the menopausal

hormonal fluctuation, specifically due

to the decrease in in oestrogen levels.

So I would like

to ask Gillian if you

could share some evidence

specifically advocated

for menopause being this

critical inflexion point

in women's life that exposes her

to increased susceptibility

for Alzheimer's disease.

- Yeah, so just as Claudia

had beautifully taken us

to there, we have this whole

like of events that happen

around menopause and then you know,

we as Alzheimer's disease researchers,

we're studying women usually

in their kind of mid seventies

and looking at levels of

these neurotoxic proteins

that cause Alzheimer's

disease essentially.

And so what we do is

we look at these women,

we image them for these

neurotoxic proteins

and then we look back to see

how they experience menopause basically.

Now typically we don't have data sets

that can look at the fluctuations

in the hormones around menopause

and link them to later AD biomarkers

like these neurotoxic proteins.

But what we can do is we can look

at how women experience menopause

in terms of their menopausal

symptoms which will be proxy

for those hormonal fluctuations.

We can also ask them, you

know, when did they have

their last period,

which would be their age at menopause

and then we can also

ask them whether or not

they were treated for

menopausal symptoms with HRT.

And so I guess one of the

things we've learned so far

is that if women move into

this kind of menopausal

or perimenopausal state

earlier than expected,

so particularly before the age of 40

or maybe between 40 and 45,

those women seem to be at a higher risk

for depositing these neurotoxic proteins,

amyloid and tau later in life.

So that association has been

shown in neural imaging studies

but also shown in these, you

know, epidemiological studies

that show that the age of menopause

is associated with Alzheimer's

disease prevalence.

Right, so then we look at the biology

of what that link could be.

In terms of hormonal fluctuations,

we are writing grants at the moment

and I do know a couple of

other scientists in the US

who are writing grants to look

at how all of those events

during perimenopause change

the women's brain structure

and function in real time.

So not necessarily

looking at women's brains

down the line like we currently are doing,

but in real time

as the fluctuations in the

hormones are occurring.

So some of the leading scientists

in that area right now

would be Roberta Briton,

but also, you know, Emily

Jacobs, they have a grant

kind of basically looking

at exactly these questions.

Also Caitlyn Castello,

she's another scientist

who's very prominent

in this area and then ourselves.

So me and Rachel Buckley,

we're also proposing

a grant to look at perimenopausal effects

and how that implicates the brain.

In terms of what we look at in the brain

in menopausal women, we don't look

for the proteins of Alzheimer's disease

because it's very unlikely that they exist

at that stage, right?

So typically, if menopause

is going to increase

women's risk of Alzheimer's

disease, we won't know

that will have officially

happened until they are at the age

where they can actually start

depositing these proteins.

So what we instead look at

is these other risk factors

that might suggest that

women are on the road

to preclinical Alzheimer's disease.

And so some of those things

would be like more the plasma biomarkers.

Also things like inflammatory

pathways, vascular pathways,

looking at brain structure

and function of course

and brain structure,

particularly in subfields

of the hippocampus like the CA3,

that would be a kind of region

we'd be particularly interested in

in these menopausal women.

And then looking at, you

know, the structural integrity

of white matter tracts,

those kind of things.

So those biomarkers are

more likely to change

due to menopausal changes.

And then if they do change,

that kind of puts the brain

in a more vulnerable state

to deposit these neurotoxic

proteins later down the line.

And it's really the proteins

that underlie the actual onset of symptoms

related to Alzheimer's disease, at least,

of course there are other dementias

but we focus mostly on Alzheimer's,

so there's a lot to unpack.

Basically the way we're

doing at the moment

is, as I said, we're looking at,

we have this big space of time

between when women report menopause,

menopausal symptoms and

their menopausal age

and then we get pet scans

on them 15 years later.

Whereas the way the field is moving

is to actually do those imaging studies

as the women are actually

going through menopause

and that will be able to,

that will tell us a lot more

basically about how menopause

leads women at risk, potentially

could leave women at risk

of cognitive decline later in life.

- So we are seeing that definitely

a lot of retrospective studies

have laid this foundation

where we are now knowing or

learning about how menopausal

or menopausal related

factors are associated

with later accumulation

of these toxic proteins

but also of structural changes

that then also as you said,

kind of lead the brain to

become more vulnerable later on.

And you mentioned one

of the risk practises

that you have done in

your research is actually

the earlier age of menopause

and most of the people

probably think of menopause

as a natural process

as it comes to ageing,

but obviously we have

different types of menopause

such as surgical menopause.

So could you maybe comment a bit on that?

- Yeah, so I think the original hypothesis

was that it was probably

surgical menopause

that would be women at risk

and we're seeing in our data

or at least the data sets we work with,

if not so much the fact

that it was a surgically

induced menopause,

it's more just that the

menopause was early, right?

So you get this earlier than expected

deprivation in circulating

estrogens, et cetera.

And then the fact

that this happens earlier than it should

is kind of having the detrimental effect,

as opposed to it being

surgically induced as such.

At least that's what we're seeing

in the data we look at

from the Alzheimer's disease perspective.

But just by nature of having a

surgically induced menopause,

then that is likely happening

earlier than the average age

of menopause, which is 50, right?

It it's probably happening

before the age of 45

if not before the age of 40.

So I think, you know, when we do

kind of interviews we also say

it is important for women

to always kind of know what's happening

with their reproductive health

and know if they're getting, you know,

surgically induced menopause

that that is happening

for the right reasons

or at least it's really

necessary in their case

'cause it can have implications

for women brain health

and then you know, the brain

health later down the line.

- Okay, so obviously that

becomes less clear then,

it's not just again

the type but maybe the age

but then again maybe there

is something behind that

that we don't know yet

and probably we don't know how to quantify

because historically the data

sets that we are working on,

they don't collect that data

or if they collect, it's not to the extent

that we would like to.

So I would like to now move a

little bit from what we know

to what we will know

based on both of the work

that you are doing and

specifically maybe talking

a little bit about the

historical blind spots

in terms of the methodologies,

these ageing cohorts

or Alzheimer's disease

cohorts have been using.

So obviously like we know like ADNI

which is Alzheimer's Disease

Neuroimaging Initiative,

but we also have more huge data sets

that are looking specifically

into how individuals

develop Alzheimer's

disease from preclinical.

So this asymptomatic stage

where the proteins start

to accumulate but yet in the absence

of any cognitive symptoms,

but none of these data

sets have considered

sex specific variables

or perhaps to a very, very brief extent.

And why do you think that

was the case potentially,

and then the follow up

question, what would be

your kind of perfect list

of reproductive variables

that you would like to

include in your studies?

Because I know both of you

are spinning big brands now.

So let's start with Claudia

and then go to you Gillian

with your wishlists.

- So yeah, that's a good question

because like I've in the past

mainly used like UK Biobank

which is a big UK based population sample

covering 500,000 individuals

and the nice thing of the UK

Biobank it started collecting,

so inclusion ranges

between like 40 and 70,

which again is already

like actually a bit younger

than the most ageing cohorts,

which normally starts at the age of 65

historically rooted into

based on the retirement age

in most countries.

And the UK Biobank

actually does cover the

menopause transition,

but it has surprisingly little variables

on this particular aspect

and has no variables about symptoms.

And also it's really hard,

we tried multiple times

to varying degrees of success,

to really establish if women in this court

perimenopausal.

So yeah, simply knowing

if women have symptoms,

if they had symptoms as Gillian said

and that they ask retrospectively,

how did you experience

the menopause transition

is super important

'cause that varies a lot

and, and there is more

and more indication that

the severity of symptoms,

the number of co-occurring symptoms,

what kind of co-occurring symptoms,

how long they last

might really be critical

for how women might age later in life.

So like questions around that

are really, really important.

Then past reproductive history

we have found associations

between a number of life births

and the ageing brain later in life.

So these kind of variables

are really important

if women have used hormonal contraception,

can be very insightful to

know for later brain ageing.

And so there's like, yeah,

like now that I'm starting acquiring data

across perimenopause,

like I'm setting up this like

massive baseline questionnaire

about reproductive factors

and past histories and aged menarchy

and like trying to really kind of map out

all the reproductive years

as kind of comprehensively as

possible to really kind of see

what we found in the UK

Biobank, if that replicates

but also how that informs

how women actively life

as Gillian said earlier,

experience perimenopause.

So my grant really also

kind of has a strong focus

on like symptom mapping.

So we are using an industry partnership

to have an app really for

the participants to be able

to on a daily basis record

their their symptoms

and their experiences

because I think that's a

really big, big missing part

in all of these cohorts.

It's first of all that symptoms

are not really acknowledged

but also it's mainly you have one,

two, three maybe time points.

So having also more densely sample data

across these critical inflexion points

is really, really needed.

And I'm really happy to see the trend

towards like focusing on perimenopause

and then focusing on longitudinal studies

during perimenopause

because I got money to do my part

but we need like

comparable samples globally

so we can really look

for robustness of effects

and generalizability of effects

and also to be able to tap

into biopsychosocial aspects.

How does it differ between countries?

Does it differ between healthcare systems?

How kind of the experience

of perimenopause,

transition impacts ageing later on life.

And there are already

kind of some indication

not from imaging studies

but more also from when it comes

to attitudes towards

menopause and mental health

because of attitudes towards might differ

between societies and

between societal structures

and between potentially the western

and kind of the global

north and the global south

and all these kind of differentiation.

So it's nice we are

going in this direction

of having more varied approaches

although it is still kind of clustered

to the global north I have to admit.

But yeah, that's more symptoms,

more dense sampling

and ideally in the long run,

also much more diverse samples

which is not just white women.

- Thank you so much for

sharing your study as well

and what you're gonna be doing

with this highly phenotyped cohort.

And you were obviously saying

that this is the global north

but since we were talking about Germany

and European perspectives

because of your study

and my curiosity is what is

the situation on the other side

of that Atlantic ocean and

how are you gonna measure

and quantify your participants Jillian?

- Yeah, so where to start really?

So I think, well when

it comes to you know,

what we would ask women,

Emily Jacobs is actually putting together

this standardised questionnaire,

you guys know about it.

It's where all researchers

in, you know women's health

can basically use the

standardised questionnaire

which really covers the scope

of things related menopause,

timing, symptoms, et cetera,

but also hormone therapy type

of hormone therapy dosage,

you know, et cetera.

So I think that will probably

be incredibly valuable

to the field at large

and probably also using a global scale,

not just necessarily in North

America I wouldn't think.

And so the interesting

thing about women's health

is that, you know, in maybe 10 minutes,

we can acquire a huge amount

of data on women's reproductive health,

at least by participant self-report,

which has some limitations

but it still would be an awful lot better

than kind of the relatively sparse amount

of data we have on Women's

Healths from these big data sets

that we work on at the moment.

So there's been a big push for, you know,

studies like a acne,

the Wisconsin Registry

of Alzheimer's Prevention, the

Harvard Ageing Brain Study,

all of these kind of open access data sets

to start including these questionnaires

as part of their screening processes.

And so I think there is

a shift towards that now.

So in the next five years in particular,

I think we'll have a whole

host of kind of new data

that we can work with

from those data sets.

In terms of new studies that

we're doing, a lot of it

is collecting blood samples from the women

as they go through perimenopause.

So these are more focused studies

on you know, menopause AD link

and then also using those blood samples

to run new, which can basically allow us

to capture all of these

kind of inflammatory

and vascular pathways

and potentially cope

apologies too like TBD 43,

and things beyond just

Alzheimer's disease.

So I think the studies

that we're designing now

specifically to look at menopause,

we'll be relying heavily on blood samples

and looking at hormone levels

and all of these other biomarkers.

But you know, when we

think about these current

big scale data sets that are out there,

just bringing in these

women's questionnaires

will also open us up to

a whole kind of new field

of data analysis.

- Thank you so much and

obviously your wishlist

allows, you know, all of our listeners

who are also potentially thinking

about conducting such studies,

pay attention to variables

that you have mentioned today.

I also thought about

something that Claudia,

you mentioned about the

industry collaboration.

This is not still a common practise

in research environments.

Could you tell us how is your journey

with establishing that collaboration

and how that collaboration will help you

and how you using those industry supports?

- I kind of used to say when

people ask me about that

that I'm just lazy

because I don't need to reinvent the wheel

or if they're much people out there

already kind of doing the work,

'cause for my study, like

we have repeated imaging,

we have repeated blood samples

and we have like all

the standards we've done

in previous studies but

then I was like, okay,

how do we actually like

really tap into symptom

and experiences and there is already

apps out there doing that.

And so I reached out to Clue,

which is a Berlin based menstrual cycle

tracking app startup.

And finally when I wrote my grant in 2023,

like they just released a

perimenopause mode in September

and my deadline was in November

and then I just texted them

and said like I'm preparing this grant,

I just saw you release this board,

I would love to use

that in my participants.

Would that be like,

are you interested in

collaborating and so on so forth.

And they were super open

so it was like very easy

and gave me a letter of support.

I budgeted for that.

And so it was like a nice story

and now we are kind of going back

and forth also how we could

use already acquired data

and other kind of angles to really using

the data these EmTech startup,

digital EmTech startups

already collecting based

on their user base.

And Clue has a very nice kind of setup

where like in app you also already use

if you like already ask if you want

to participate in

scientific research studies.

So that was really reassuring

so that they already have

very strict pipelines for research

and also very pragmatically

for my context being in Europe

because it's a Europe based startup,

it also follows all the kind of GDPR,

which is like privacy

law regulations in EU.

So that was also very

attractive for me personally,

knowing that they would follow

the data protection standards

we would need for research.

So for me that was a win-win.

- That's really inspiring to hear

that you have had a

really positive experience

and obviously since we are talking

about really highly dense

sampling methodologies

for our symptoms and

potentially biomarkers,

I think also the future

of research and especially

women's health research

should move from just

laboratory based studies

to more remote settings.

And these platforms, these

collaborations would allow us

to collect the data,

whether it's symptoms,

whether it's some type

of sleep measures from the wearable device

or even like blood-based biomarkers

that obviously could be done

through the health providers

and then they could put the information

related to the sampling

time on their application.

So I think there's

definitely way more bridges

that need to be billed between industry

and research in order to

propel what we are doing.

And maybe fast track a little

bit more in the future.

So our time is running away today,

but it's been a really rich

and great conversation about the menopause

and why this midlife transition

has been really important.

(upbeat music)

Before we close, I would really like

to just bring one personal

question to each of our speakers.

What does women's brain health mean to you

briefly in one sentence?

Personal Claudia.

- It means ageing gracefully

and as best as possible

and by more research we can do that.

- Beautiful, Gillian.

- I think women's brain health for me

means sort of the forefront of research

and really coming out of the rug

and understanding everything there is

to understand about women's brains.

- Thank you, so that's

it for the second episode

of XXplored, a huge thank

you to both Dr. Claudia

and Dr. Gillian for your insights

and really taking us through

this difficult period

in women's life.

But hopefully it's just

brought a bit more light

and a little bit more understanding.

And as I reflect on the things

that we have discussed today,

there are a few points

that kind of really struck a chord in me.

And one of them is both your research

and what you're doing on

opposite sides of the world,

trying to bring the woman's brain health

and specifically during that

critical vulnerable period

where it coincides with

Alzheimer's, preclinical stages

of the disease and the

multitude of methodologies

that you are using and trying

to navigate the questions

that you are posing from multiple angles.

And I think that just kind of highlights

how still under researched this area is,

but with having such work

coming up in the future,

I'm definitely feeling a bit more assured

about my own brain health

and also the health of

our parents hopefully.

And then another also

aspect that probably also

our listeners are gonna leave with

is that it's not just that one time

during the women's reproductive phase

and it's not just the menopause,

it's not just the stop

in the menstrual cycle,

it's not just the drop in oestrogen,

but it's actually the

lifetime exposure of oestrogen

through variables such

as number of children

also the age at Menarchy,

different pregnancy complications,

and as well as other

risk factors that happen

during the whole life

that all kind of shape

a woman's brain and may

increase ones' risk.

So thank you once again for

this great conversation.

I really hope that both of you

can reconnect in conferences

and also we can bring more research

from these great ideas.

- Thank you very much for

this nice conversation.

- Thank you Laura.

- So I'm Dr Laura Stankeviciute

and you have been listening

to XXplored, Women's Brain Health

on the Dementia Researcher Podcast.

(upbeat music)

- [Voice Over] Thank you

for listening to Xxplored,

Women's Brain Health podcast

from Dementia Researcher,

with generous support from the

National Institute for Health

and Care Research,

Alzheimer's Association,

Alzheimer's Research

UK, Alzheimer's Society,

and Race Against Dementia.

From hormones to cognition,

from risk to prevention,

we feature conversations

with researchers, clinicians

and change makers working

to challenge assumptions

and close the gaps in how we understand

and support the female brain.