So far there's some overlap with "The XX Brain" where this book repeats some of the same content. For example- bikini science, how science has ignored females in research studies, no research on female brain, female brain is different than male brain.
Starts out defining the different types of menopause, the stages of menopause and reproduction. Menopause is when you have your last period, and after 1 year with no menstruation you are in post menopause.
Next, it states that the brain changes in menopause and she calls this "menopause brain." There has been evidence of less brain activity compared to the premenopause brain. This could explain "brain fog." I had more brain fog post partum so I'm wondering if pregnancy changes the brain too. And is there a "post partum brain. " Because post partum was more difficult than menopause for me.
I'm most interested in finding out what causes hot flashes (low estrogen? Or the hormone change?), and if hormone replacement therapy is beneficial to prevent Alzheimers and dementia, and any other benefits vs. possible risks. I'm wondering if there will be any mention of what made me sad in menopause- the fact that having the ability to have children is over.
A lot of the same information from both XX Brain and Brain Food especially about foods and diet, exercise, sleep, and water, stress reduction, etc.
Notes on what I found important--->
The brain changes during menopause- developing new neurological and mental skills.
"Menopause is a mind-body experience. "
Sex hormones are involved in brain function.
Ovaries make small amounts of estrogen, testosterone, and androstenedione after menopause.
Symptoms- hot flashes, overactive bladder, joint pain and stiffness, muscle aches, breast soreness irregular heartbeat and palpitations, slower metabolism, bloating, reflux, dry skin, sleep issues, fatigue, dizziness, headaches.
Hot flashes- vasomotor caused by constriction or dilation of blood vessels.
Brain-Ovaries connection-
Hypothalamus: controls body temperature, sleep patterns, appetite.
Pineal gland: secretes hormone melatonin to signal sleep
Thyroid gland: regulates metabolism and temperature.
Pituitary gland- makes hormones
Above glands are involved in the HPG system/connection (Hypothalmic-pituitary-Gonadal) (Ovaries =gonads)
This connection is responsible for menopause symptoms.
The brain is estrogen-fueled, it runs on Estrogen. Estrogen is involved in a number of brain processes. (Pg 67)
Menopause symptoms are the consequences of receptors in the brain getting less of the fuel (estrogen) they need.
3 types of Estrogens-
1. Estradiol- most potent and abundant during reproductive years, produced by ovaries. Reduced levels after menopause.
2. Estrone- made by fatty adipose tissue, weaker effect than Estradiol. Main type of estrogen produced after menopause.
3. Estriol- pregnancy estrogen
Estradiol is the one mainly interacting with the brain, involved in many brain processes- master regulator. See pg. 69 for details.
After menopause, Estrone is now used.
*Since the Hypothalamus controls body temperature, the instability in Estradiol supply means the brain can't regulate body temperature correctly = hot flashes. *
Brain energy changes seem to be temporary, and rebound in energy during late postmenopausal stage, about 4 years after the last period.
Menopause is a neurological transition where the brain adapts and changes to compensate for and maintain brain functions despite the estrogen drop. P74
Supermom brain-
Hormones oxytocin - love and vasopressin- maternal aggression "mama bear" protecting and defending. Mom GPS/tracking. Adrenaline rush. Mom brain leads to theory of mind and motherly instincts.
Menopause shrinks uterine fibroids.
HRT= Hormone replacement therapy-
According to this book, HRT is now safe, as long as started within 10 years of the lmp.
If taken within the 10 year window, hrt is associated with reduced heart disease, lower mortality rate than those who didn't take hormones. (Pg 121) hrt may also protect against cognitive decline. Reduced risk of hip fracture, colorectal cancer, diabetes. (Pg 122) HRT started in midlife may help reduce dementia risk - in the absence of more definitive findings, HRT is not recommended to prevent or treat cognitive decline or dementia. Dr. Mosconi hopes the recommendations will change as more evidence is gathered. (Pg 129)
Ie more research is done!!!
Bioidentical hrt- same as ovary produced estradiol. Micronized progesterone is a molecular replica of progesterone made naturally.
There is little evidence that combination bioidentical estrogen and progesterone increases breast cancer risk.
Government approved and compounded bioidentical hormones- each ingredient is regulated and monitored for purity and efficacy, tested for side effects.
Designer estrogens. SERMS. - a type of hrt to support brain function Hopefully someday this is available.
Dr. Roberta Diaz Brinton, her colleague, developed PhytoSERM, for the brain. Estrogen from plants. Supplies estrogen directly to the brain, bypassing reproductive organs so no cancer risk. They did a clinical trial, results available in 2025. With clinical validation, they hope it will prove valuable to address menopause symptoms and provide extra protection for the brain, protecting against dementia. (Pg 130) I definitely want to watch this!
Non hormonal treatments-
Paroxitine antidepressant for hot flashes.
Gabapentin and clonidine for menopause symptoms.
Fezolinetant for hot flashes.
Chapter 12 Gender-affirming therapy doesn't belong in this book about menopause.
Part 4- lifestyle --- Is the same mostly as her other books Brain Food and XX Brain.
Estrobolome- gut bacteria that metabolize estrogen. Keep things in balance, ensuring that the overall amount of estrogen is just right. (Pg 196). Keep it happy by eating a variety of plant foods, high fiber. Avoid processed foods.
Eat foods with phytoestrogens. 3 types-
1. Isoflavones- soybeans, tofu
2. Lignans- flaxseeds, sesame seeds, garlic, winter squash, wheat grains, pistachios and almonds
3. Coumestans - sprouting seeds
Phytoestrogens function similarly to our estrogen but are weaker- a thousandth of the strength of estradiol. Effects are milder. Only have an effect if consumed consistently.
Increase absorption of plant iron (non-heme iron) by combining with foods rich in Vitamin C. Berries with oats, lemon juice on salad or spinach. Heme iron is in meat and absorbs easily.
Eat organic dairy free of growth hormones.
Pistachios are the most melatonin rich food. Eating a handful is equivalent to taking a melatonin supplement before bed. (Pg 208)
"In the last 70 years, nearly 100k new chemicals have been released into the environment via our food & water supply. At least 85% of these chemicals have never been tested for health effects in humans, so their safety quotient is unknown. Among those that have been tested, as many as 800 chemicals are either known or suspected to negatively impact our health, especially our hormones. " (pg 242)
EDCs= endocrine disrupting chemicals or hormone disrupters. They are chemical contaminants that mimic natural hormones, and prevent cells from communicating. Many mimic estrogen-- xenoestrogens.
These chemicals are toxic to the brain.
Note- I'm going to look up xenoestrogens/ hormone disrupting chemicals. Never heard of this before.
The book ends with this-
"Are you losing your mind during menopause? No, you're getting a brand new one." Pg 264