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In my latest episode, I had the pleasure of speaking with clinical neuroscientist Dr. Lisa Mosconi, author of the recently released book “The Menopause Brain.” Our conversation delved into the fascinating realm of women’s brain health not only during menopause but also the earlier stages of life. We explored the intricate changes occurring in the teenage brain, both in males and females, as well as the developments in the 20s, 30s, and beyond.
What struck me about this discussion is Dr. Mosconi’s deliberate decision to focus on women’s brain health many years ago, recognizing the prolonged period of menopause and perimenopause compared to men’s experience. She emphasizes the myriad lifestyle interventions, from hormone replacement therapy to supplements and physical activity, that can safeguard our brain health as we age.
Whether you’re male or female, there’s a wealth of valuable insights in this conversation, particularly for women navigating menopause. Enjoy!
Resources Mentioned:
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Time Stamps:
- 00:04:14 – The Menopause Brain
- 00:15:20 – The Genetics
- 00:24:19 – The Impacts of Thermoregulation
- 00:26:45 – Handling Stressors
- 00:30:37 – Teenagers and Puberty
- 00:38:27 – Managing the Ebbs and Flows
- 00:43:43 – The Brain-Gut Connection
- 00:46:29 – Getting Started with Menopause Management
- 00:53:51 – Menopause is Not a “Life Sentence”
- 01:00:15 – Hormone Therapy
- 01:06:14 – Effects of Electronics
Show Transcript:
Gabby [00:01:51] Doctor Mosconi. How does a girl from Italy become a neuroscientist?
Dr. Mosconi [00:01:57] Well. I wanted to be a neuroscientist when I was, like, six, because my parents are nuclear physicists. Both of them. And. Yeah. So. Yeah. Yeah, it’s an interesting. I have an interesting family. Half of my family has a PhD. The other half is in the Army. So we’re really. Yes. It’s an interesting mix.
Gabby [00:02:23] So when they get together there’s either verbal beating or it could be a physical beating?
Dr. Mosconi [00:02:31] Yeah. No, we’re very, very peaceful actually where there’s like a. 1 to 1 matching. Like for one person who. Goes to college and beyond, another one joins the army. It’s very it’s just strange. Yeah. But anyway, my parents are nuclear physicists. And my mom. Used to teach nuclear physics to students who then transition to nuclear medicine. And they would babysit me. And talk to me about all these wonderful things that they were doing. So scanners and radioactive isotopes and, you know, decay and position decay. And they thought it was the coolest thing ever. And so I always wanted to use those machines, but it was also interested in, in cognition and intellectual. Pursuits and who knows what else. So yeah. I was about six when I said. That’s it. We have a plan.
Gabby [00:03:25] At least your parents can handle raising you. I think if I had a kid at six who’s like, hey, I’m going to be a neuroscientist, my husband and I would be in a lot of trouble. So I say.
Dr. Mosconi [00:03:33] That’s funny. You know, my daughter is eight, and she said to me the other day that she wants to be a scientist, but she wants to study chemistry, and she also wants to be a robot engineer that specializes in health. That’s right. That’s it. It’s the perfect combination between me and my husband. It’s like fusion. It worked. You know.
Gabby [00:03:57] It’s funny, I was reading something recently of a brain surgeon who said, absolutely, humans should not be doing brain surgery, and he’s now navigating, controlling the robots to do the brain surgery. So she she’s already ahead of the deal.
Dr. Mosconi [00:04:10] She’s way ahead. She’s ready.
Gabby [00:04:14] So how how do you are you surprised? I mean, this is, your your this latest book of yours is one of many books you’ve gotten brain food. The. You know, now you have the menopause brain. You’ve had the brain when you started this out. What what application did you think you were going to be using your education for? And and then and why did you now add an adjunct to writing books to communicate to, to to people, to give them the understanding themselves?
Dr. Mosconi [00:04:46] I think it’s really important to take the. Research out of the lab. And it doesn’t matter how many papers or articles I publish, if the information does not reach the people who actually need it. And I think when it comes to women’s brains and women’s brain health, it’s still considered very niche in science and medicine. Many people do not. There aren’t that many people who do the kind of work that we do, and the information is just not reaching the women who need it. So I thought, well. It’s really not about me. It’s more about making sure that we all know how to take care of ourselves and how to take care of our brains. And it’s important to really communicate the right information in a way that is scientifically sound, because there’s so much misinformation out there. So I thought that it would be hopefully helpful if I also used a little bit of my voice to help others. I think it’s really the reason we do science in the first place is to help others.
Gabby [00:05:57] In your book you talk about, and this is something I didn’t know that two thirds of Alzheimer’s patients are female. So I, I’m wondering, I often wonder because, you know, stress and lifestyle and all these things, you know, contributing to this if you if you feel like that, that has been something that is a kind of a modern day, you know, we used to talk about heart health. Men were the only ones having heart attacks. And now we’ve gotten to catch up because we live a modern life as well with modern day stresses. Do you think that if we went back 100 years ago that that would be a different case?
Dr. Mosconi [00:06:36] About Alzheimer’s disease? No, I think that. So this is a very good question, actually. When I started looking into Alzheimer’s disease and the female prevalence of dementia, that was, when I started doing my PhD and nobody took me seriously, and they were telling me, it’s only that women live longer than men. That’s the only thing. So they would say to me, Alzheimer’s disease is a disease of old age, and women live longer than men. Therefore, unfortunately, more women than men develop timing, disease and dementia. And that never makes sense to me for two reasons. The first reason is that women don’t live that much longer than men in the United States. The gap is about four and a half years, but in England, it’s only a two year difference in Alzheimer’s disease and dementia are the number one cause of death for women and not for men and those. So we went back in time. There was always the same age gap. The longevity gap was quite similar. People would not live. That long. But women always outlive men. But just a couple of years, not ten years, not 20 years. So that really made no sense. And the other part is that Alzheimer’s disease does not happen overnight when you’re old. It’s a kind of progressive disease. This starts with negative changes in the brain. Years, if not decades before the symptoms become clear. And clinical examination is like heart disease. You know, we get high cholesterol. There’s a buildup of plaques and inside the arteries and the vascular system. But it takes years to get to a point where a person actually gets a heart attack. And the same thing happens in the brain is a very slow process that takes time. So Alzheimer’s disease is actually a disease of midlife. With symptoms that start when we are old. And this has been the vast majority of my research from my Ph.D. onward, has been really to show that Alzheimer’s actually starts when we’re young. It just it moves quite slowly for most people, which then change the whole question. Right? If we’re looking at midlife, what happens to women and not to men in midlife? It could potentially trigger Alzheimer’s disease in their brains, or at least explain the increased risk of dementia. And any. Woman can tell you that. A number of things happen in midlife from higher stress, less sleeps, huge amount of obligations. Not having time for yourself. Ever. Most women stop exercising at midlife. Most women start in comfort food. Even in life. For bingeing. Not all women, obviously, but there is midlife stuff. And on top of all this, there’s a root cause, right? Which is menopause. And nobody seems to realize and think in men. But that is a society. We do not acknowledge that at all, that menopause is not a day on the calendar. Menopause again, is a process, right? The transition can take a decade. And it’s rough. It can be rough. It also really can impact the health of your brain. So I think there’s just the perfect storm the hits get can hit women in midlife. They can also potentially impact brain health. And we need to talk about it. Really do.
Gabby [00:10:14] I mean, we were joking about you that you come obviously from a smart family and. But yet you have this, this softness and and kind of quiet. Where was it in you that you thought, okay, they’re not taking me serious there because I think people come up against this in their life. It’s like, hey, I have an idea. I have a hunch, I have a feeling I’m looking at things. And is it true that a lot of studies were only done on men right till about 1996? So when we’re talking about fasting and muscle, I would assume it’s kind of across the board for some of this conversation, right?
Dr. Mosconi [00:10:46] Yes, for sure. So women were excluded from most research in the 1960s and were only reintroduced in the 1990s. And even after that, in my field, in the field of neurology, the vast majority of research has been done on men. And there’s, there’s something I refer to as bikini medicine, which is this idea that essentially women are like smaller men with different reproductive organs. So it is like saying that from a medical perspective, what makes a woman a woman are there’s body parts you can put under a bikini and nothing else. And this is really extremely pervasive, to the point that we have been studying men’s brains as the paradigm for the human brain, assuming that there would be no differences between a woman’s brain and the means by which is is completely bananas. Is completely in any anyone, almost any men, I can tell you. That makes no sense, right? Yeah. But the neuroscience, neuroscience, neurology, unfortunately, sex differences are usually completely overlooked or accounted for statistically. And then we have a problem because we have research on brain health that’s done on men and men. Men’s brains do not age the way that women’s brains do, in part because men don’t go through menopause.
Gabby [00:12:15] Right. They go through your pores, which comes much, much later. It’s like we could start some women, you hear, late, even 30s, hopefully. You know, that’s like, I don’t want to say worst case scenario, but the most, you know, kind of extreme and then, you know, moves up from there and can go on, like you said, for ten or even I, I have a friend who’s like, yeah, no, I’ve been going through this for ten years, you know, with the hot flashes. And I’m like, are you kidding me? So but I just before I move off of it, we’re inside of you. I’m always interested when people can go against an unpopular either thought or or question, where do you within yourself go. Yeah. No, I’m I’m going to dig into this.
Dr. Mosconi [00:12:56] From the beginning. So the reason I’m starting Alzheimer’s disease is, is my family. I have a family history of Alzheimer’s disease that affects the women in my family. So my grandmother on my mother’s side was one of four siblings, three sisters and one brother. In all, three sisters developed Alzheimer’s disease and died of it, whereas the brother was spared. So for me, that was terrifying. It was. I mean, the idea of not being able to use my brain is absolutely terrifying to me and to my mother, of course. Yeah. So first, it was really personal. And then I moved to New York, so I was doing my PhD. I was born and raised in Florence in Italy, and I started my PhD at the University of Florence. And then I transferred to NYU, the School of Medicine in New York. And when I was there, I was so fortunate. Then I joined the team that was led by Doctor Moni de Leone, who’s really a pioneer in the studying of early onset Alzheimer’s disease and the early detection of Alzheimer’s. And he immediately was on board when I said to him of really interested in sex differences. He was like, right, do it. And so we started doing this research together. No, I mean, it’s it’s a blessing. I know that my my story is very, I’m just extremely lucky. I know a million people who. Who will tell you from sentimentally that I’m from Italy. But I was very fortunate. And we discover that having a mother with Alzheimer’s disease seems to put the children at higher risk for Alzheimer’s, as well as compared to having a father with Alzheimer’s. And that study was published in a really prestigious medical journal, which opened a lot of doors for us to keep pursuing. That line of research. And then I moved to Wise Medicine, which is where I work now, because my chairman, the chairman of my department, Doctor Matt Fink, actually really wanted me to start this Women’s Brain initiative. So I’ve been just very fortunate to work with individuals who care about women and who trusted me with this research.
Gabby [00:15:20] I mean, I know and I love scientists because they go, well, I don’t know the science on that, but when I hear that it’s the mother over the father, do we think that’s genetic or that we it’s something to do with a lifestyle, component because people always go, I inherited their genetics. I know you inherited their lifestyle more than, I think I mean, obviously genetics in certain things, like, you see people’s skin and you go, oh, come on, that’s genetics. You know, it’s like certain things for sure. You go, hey, that’s genetics. But I think other things are not a sentence. It’s like, no, you you kind of inherited their lifestyle and you know, so do you think it’s, it’s the lifestyle component or is there really a genetic line to that?
Dr. Mosconi [00:16:01] I believe that there’s a combination of both factors that could be important. We were going after the genetic component of first, because it was very novel and it was based on information. Then, you know, we have two different types of DNA in our bodies. We have the DNA that everyone is familiar with, like the 23 chromosomes, like X and Y. But then we have another kind of DNA, which is mitochondrial DNA. And it’s deep inside there are cells, all cells also in the brain and mitochondria. DNA is important for metabolic activity and energy levels and cellular aging or cellular resilience. But it is quite unique in that where nuclear DNA standard DNA comes from the mom and from the dad by 5050. But mitochondrial DNA is 100% maternally inherited in humans. It comes all from the mom. So your metabolic activity, actually the metabolic activity of your cells comes from your mother. Which I find extremely fascinating. Which means those of you. Resilience. Is more closely related to your mom’s resilience than other factors. But then of course, lifestyle is super important. You can you can change your DNA or I mean, not structurally, but you can impact and change the functionality of your DNA by interacting with the environment or having a very specific lifestyle, whether it’s supportive or not. So you can switch your genes on and off in a way. And that’s the epigenetic component. I think both are equally important.
Gabby [00:17:48] That’s it. But that’s fascinating. I’ve never actually heard that. And, that’s that’s really interesting. I, like I said, I’ve never heard that. Could we I want to, you know, like I said.
Dr. Mosconi [00:18:00] I’m sorry. I just I just have a. Fact I think you’re going to love. Speaking of DNA and females brains and women’s brains. Did you know that when a woman gets pregnant, part of the partner’s DNA actually gets lodged within your brain and stays in your body for decades.
Gabby [00:18:21] Into the woman’s from your partner?
Dr. Mosconi [00:18:24] Yes. Because once you get pregnant, part of your, like, your husband or your partner’s DNA. Yeah, enters your body, but it doesn’t stay in the baby. It actually enters the bloodstream in the circulation to the point that it’s found in women’s brains for years after you give birth. So actually, our children’s DNA, which in part contains your partner’s DNA, is going to be within us for is being found like residues have been found for up to 13 years after the pregnancy was done in the baby was born. So, you know, genetically.
Gabby [00:19:02] I’m I’m still currently with my children’s father and and people joke like, oh, there’s some you know, you live with someone long enough to check. You become similar. More similar. Oh that’s. Oh yeah. But I have this vision of someone listening to this and they have like in their mind, a crazy ex, and they’re like, oh, you know, really? But that is it. That’s amazing. I’m never going to tell my husband that because he is, he’s a, he’s a he’s kind of nutty, so I don’t know. So you wrote your first book, x brain and then brain food and, and now this is very specific because now we’re really talking about a women’s brain and the menopause brain before we launch off only into, into, menopause because my, my audience is, is pretty 5050. If we, if we could first talk about I would love to just talk about universal truths about our brains and puberty. I’m really interested in the difference at puberty. And then we can do a deep dive into the women’s side of it. So. As far as, like, brain health. What are just universal truths for our brains as far as things that support and things that that damage from. Because I would imagine, okay, we’ve established the genetic parts. We can’t control that. Now. We move into lifestyle. First food and exercise. Are they playing an equal part, support for the brain?
Dr. Mosconi [00:20:38] I would say they’re complementary because they target different aspects of brain health. They would exercise. The benefits are both evident to genetic level, but especially at the physiological level. So the increase in blood flow, the endorphins, the anti-inflammatory effects are quite universally found, especially aerobic exercise like cardiovascular fitness, has been very well documented in terms of beneficial effects on multiple parameters of brain health. And now strength training is also receiving increasing attention for the positive effects of mood. Whereas the cardiovascular fitness seems to have stronger cognitive effects. Like, yes, it really seems to help with brain fog, with forgetfulness, with more cognitive performance, as well as body temperature regulation that is very important in puberty, pregnancy and menopause and anthropos. So it could really be a good tool because your brain and there’s one part of the brain that’s called the hypothalamus, the tiny structure. Right this large right under the thalamus. And it’s it’s involved in a lot of different functionalities, including, thermoregulation and how we’re able to modulate body temperature internally and externally in this structure. Is is highly sensitive to fluctuations in hormonal levels. So it really gets over activated during the three P’s puberty, pregnancy, perimenopause, but also anthropos for men. And that’s why women experience hot flashes or changes in sweating patterns, for example. It all the this turning point in exercise has a positive modulatory effect on the hypothalamus as well as related structures around it, like the hippocampus, which is the memory center of the brain, in the amygdala, which is the emotional center of the brain. So this is really important. And then diet, on the other hand, there’s so much you can achieve with your diet depending on the foods and nutrients that you eat. Right. You can bring in all the antioxidants that you need. They need to come from the diet. So that is a unique aspect of diet. It is extremely important for brain health because the brain is the most metabolically fat, is the most metabolically active organ in the body, and it burns glucose preferentially to make energy, which means that at the same time, it makes a lot of free radicals and oxidative stress. So it’s a little bit of a vicious circle that the brain. Needs to burn glucose to make energy. But this process inevitably produces free radicals. In the brain is the one organ that is really vulnerable to free radical formation. So it’s a little bit of a yeah, it’s a little bit unfortunate, guys, but that’s also why your brains are so dependent on our diet, because food is the only way to really obtain antioxidants. For overall health and for brain health. So that is important. And then fiber is extremely important. Lean protein, anti-inflammatory nutrients. There’s so much that one can do with a good combination of diet and exercise.
Gabby [00:24:19] And you mentioned earlier about thermoregulation. I think people don’t realize I think it’s it’s the most stressful thing we do is keep ourselves cooler, warm, right on the body at this time.
Dr. Mosconi [00:24:31] Yeah. All right. So I think.
Gabby [00:24:33] We don’t give that enough credit about how much work that takes that thermo regulating. So just to remind people the, the real importance and significance of what you just said, and then I’m just curious, selfishly, when you talk about the antioxidants, and free radicals and things like that, when people get like their, their ability to methylated, tested, is that connected to our internal like I’ve gotten my methylation tested. I’m not good with outside pollutants processing them, but I can clean up my own junk inside my body. Okay. Is that part of. Is that? Would that be considered part of our internal waste?
Dr. Mosconi [00:25:14] Yes, like for sure. Yeah, it’s definitely a waste product and it’s so important, like what you just said, because pollution has finally been recognized as a major risk factor for dementia. So it’s not only a health hazard, but it’s also a direct, a direct issue for the health of the brain, which was unthinkable for scientists for whatever reason, until just a few years ago. And it’s not just pollution, as in air pollution and gas emissions, but really all sorts of pollutants and chemical toxins that we come, in contact with on a daily basis. So pollutants that we use in food in the house, clothing, we’re literally drowning in chemicals. So it’s really important to minimize toxins around those cells and also do things that allow us to eliminate them. So like a good clearance system is really important for the body and especially for the brain.
Gabby [00:26:20] And I feel like women, we load up even more because if we wear makeup, we use a lot more products and directly on our skin. So I think that I’m sure that’s obviously in that part, that super mixture of what we have to navigate, that a lot of men that I think that they’re not obviously they’re not it’s not as complicated. They’re all the things that they’re using. You’re you’re a working mom.
Dr. Mosconi [00:26:45] Oh yeah.
Gabby [00:26:45] You you have a lot on your plate. And you have I always love to talk to people who have answers. Because then I’m like, all right, now, how does that show up in your real life? Right? Because there are certain things I know, but I still it’s like you have to have that practice in place. How do you personally. Because you’re I would imagine sitting quite a bit and have a level of stress in your life. Do you have any simple practices or just ways that you’re getting it done as a person?
Dr. Mosconi [00:27:14] Yes, I am extremely disciplined and I have a color coded calendar. Wherever everything is in my calendar, even just eat breakfast or call my mom, go pick up Lily. And then I have, I think I work at least 60 hours a week and then down to 30 minutes meetings back to back all day long. So I really have to block out time that I’m like 30 minutes exercise, you know, 20 minutes, take a break and move and hopefully have lunch. So I just really try to stick to my schedule and then like I started working out in the morning. Because otherwise it doesn’t get done, does it? So it’s all about planning for me for as long as my schedule is as intense as it has been. That’s the only way that I can keep on top of everything. Like, I now have this dedicated window time between 7:45 a.m. and 830 where my daughter is going to school and my team is commuting to go to work. So that’s my time to exercise. And they buy the reformer. I’m so excited about that. I bought a reformer Pilates heavy downstairs. I’m loving it so now. And doing a lot of Pilates. Yeah, otherwise I really like running.
Gabby [00:28:42] And do you find, like… I feel like, make the time for the kids. And my kids are a lot older than yours, but. And even, like my husband, he’ll always he’ll he’ll be like, it’s so planned. And I’m like, well, if it’s not planned, it’s not getting done. You know, even if it’s like, hey, there’s a window here, wink, wink. Let’s go. It’s like people. I think sometimes that’s not sexy, but it’s like, sometimes I think that’s the way to get it. It’s a priority that’s, you know, whether it’s exercise or, you know, spending time with one of your family members. And, and, and I know sometimes that gets a rigid. And so how do we find places and spaces to, to not be so rigid. But, but really it’s I think for a lot all of us, it’s like making sure that we’re conscious and it’s it’s in the mix, you know, because otherwise it goes by the wayside, especially exercise. And I think time with a partner, those go out the door.
Dr. Mosconi [00:29:37] For time for yourself.
Gabby [00:29:39] Well I feel like I exercise, I go off for me. I’m like, okay, that’s your time right now. There’s going to come a time where maybe I there it’s different, you know, or go outside or take a walk for ten minutes or whatever. But, you know, just to remind people, you know, all of the things and you’re having to figure it out too.
Dr. Mosconi [00:30:09] Nobody can touch my calendar. People have tried. And the answer is always not because they schedule me incorrectly. Like they will schedule me for a budget meeting, then a meeting with a statistician, then maybe and talking to the New York Times. And then in doing something completely unrelated, I was like, no one can function this way. Yeah, you can’t do it. So I manage my own calendar and people think I’m nuts, but it works.
Gabby [00:30:37] You seem like you’re staying calm somehow through this. So puberty for boys and girls, I mean obviously boys are getting a jolt of testosterone, and I know that that is their protective hormone of their brain. So so what what is different when they’re going through puberty? I mean, obviously, the hormone situation is very complex, but just on the brain side, what shows up as being really different between the two in development.
Dr. Mosconi [00:31:07] The timeline is different, and the parts that are activated preferentially or changing preferentially are a little bit different as well. So what we know about puberty is that, it’s a major neuroendocrine transition state, which means that your brain and your hormones are changing together and evolving and rewiring themselves. But I think what people don’t realize is that puberty impacts the brain just as much as it impacts your body. So the changes in the body are obvious. The changes in the brain are not obvious, but they take the shape of a restructuring and rewiring. That actually leads to almost half of all your neurons being gone. Yes, there is a massive pruning that takes place during puberty. Yes, but that’s why adolescents exhibit this kind of unpredictable behaviors where one moment they’re they’re lovely and cuddly and happy, and the next moment they’re suicidal. And it really is due to the fact that a lot of neurons are being shed, and the neurons to their left are getting stronger, embedded, interconnected. And for women in particular, so for both boys and girls, there’s something very interesting that happens in the brain, which is them, the primitive part of the brain, very deep inside, in the middle of the brain, develops first, whereas the frontal cortex, which is in charge of planning and thinking and reasoning. Yeah, and inhibiting that behavior is late to the party. And so we have these very highly reactive structures in the middle of the brain that kind of dictate behavior. So one moment you’re forgetful, one moment you remember everything, and one moment you’re like sobbing. The next time you’re right on top of things, because these parts of the brain are trying to connect to each other and make you behave rationally. Right, and the reason for it is actually a beautiful reason that the brain is rewiring itself in a way that is more efficient. So all these neurons that were needed for you to figure out how to tie up your shoelaces are no longer needed, because now you can do it on autopilot so they can go on all the neurons. They were helping you, figure out how to get out of the door with your backpack and shoes on. Those technical should be able to go to does all these things that now you can do without having to think about all the different steps. So those neurons can go. But at the same time there’s pruning and shedding, which is better for your brain by the brain is canny, leaner, meaner, if you will.
Gabby [00:34:10] Yeah, meaner is right.
Dr. Mosconi [00:34:17] (Laughing) Yeah, I’m not there yet. No, but I’m working on it. I’m explaining all this to my daughter. So that she is ready when the time comes. Every growth spurt comes with a rewiring that makes you stronger and more mature in the member of society, but also makes you maybe stressed. Or maybe you can’t sleep the good and maybe you cry for no reason. So she gets it and she’s actually explaining it to her girlfriends and they love it. But the bottom line is that, the teen brain, right? We always say it’s a little bit of a mess, but in reality, it serves a very important evolutionary purpose, which is that the brain regions that are important for theory of mind are getting stronger and ready to go. And this is the part of your brain that allows you to, number one, have empathy. And number two, to put yourself into another person’s shoes, which is key to becoming a group. Civilized society is made possible by our brains undergoing these changes. So there’s a reason for the pain.
Gabby [00:35:26] I always think as a parent. It took me a while. I have I have three daughters and my youngest is already a junior in high school. So I, you know, you always learn everything when they’re done. You’re like, oh, I yeah, now I know how to do that better. And they’re like, yeah, okay. That good job. Five years later. Sometimes just observing and listening and not reacting to them, reacting and understanding. Because one of the things I always fear is like especially with one of them in particular, the other two is a little different. It’s like, I wonder if she’s ever going to be empathetic. And I know we have personalities that tend to be a little more or less, but I think that’s an important part of what you said, because each person in their own home starts to think, oh, this is just happening in our home. And what is this? This kid going to be okay? And I think the way, understanding that is, is so helpful because it’s just kind of giving a little more room and, you know, not reacting and not being scared and just being like, oh, okay. You know. When does the decision maker come online? Is it really is it 25. Is that true?
Dr. Mosconi [00:36:34] Yeah it’s it’s around 25. It plateaus around that age. And there’s an added challenge here because, you know, once the pruning process and whatnot is finished for boys, that’s about it. And your brain can just keep growing. And there isn’t a lot of changes at that point. But for girls we start having a menstrual cycle. Yeah, and the connection between the ovaries in the brain at that point is extremely important, because every time I bodies go through a menstrual cycle, the brain goes through a mini cycle or a micro cycle where every time estrogen is high in the body, your neurons basically grow more, they branch out more, they become more interconnected. But as soon as that as touching withdraws and progesterone kicks in after ovulation, that all goes away. And so the dendrites withdraw. And it’s like your brain. I wouldn’t say shrink because it’s not the the best word, but you know what I mean. It gets a little bit smaller, it loses energy. And that has an impact. Not like a major impact, but some women really feel it. You know, there are women who have very severe PMS. Women who do not. So there’s a range. And I think it’s really important to honor this range and be and be aware of what being a woman really means for you individually. And like I keep hearing, many doctors were like, oh, no, hey, wait a minute. Size doesn’t matter at all. It doesn’t matter. Your hormones have no impact on your brain. There’s just I being misogynistic. I’m like no, no, no. That is actually called neuroscience. You know, there isn’t that much at that time, but it has an impact. It has an impact. Yeah. You can have an impact.
Gabby [00:38:27] It must be fun for you is again you you are able to witness yourself maybe going through cycles. You have a very thinking job like you’re planning is really important. And do you do you create grace or to yourself and just go, oh, you know what? I know exactly what’s happening. Do you ever have anything that you add to support or you just kind of ride it out?
Dr. Mosconi [00:38:49] I am. I am mindful of my body. I try to really pay attention to my state of mind as well, because I am. I’m aware that if I don’t do certain things, or if I do other things that will have an impact on my mental clarity or on my ability to sleep. So I have changed my lifestyle in ways that are quite conducive, I believe, to brain health and be very careful. My husband thinks I’m nuts, but I have a lot of things that I do consistently to really support, brain health and functionality. I cannot afford to have brain fog. I cannot afford to have a bad brain day.
Gabby [00:39:37] Besides, like okay, you have exercise and food. Is there are there supplements and or is there other kind of kind of tangible things that you’re doing to, to support your, your overall cognitive function?
Dr. Mosconi [00:39:52] Yes. I have been, practicing meditation for a long time, at least ten years. I really like mindfulness insight meditation. I find it is extremely helpful to me because I sit a lot when my brain is always constantly racing. And because I don’t really have a lot of a physical outlet. Because my time is limited, then I really need to find ways to quiet in my mind. And that’s been really helpful to me. Yoga has been very helpful to me. There are some supplements to make me feel a lot better. I can’t say that they are scientifically validated supplements because, you know, clinical trials are limited. There’s only so much you can do. But I take antioxidants, a lot of antioxidants. Like I have a vitamin C spray that I use daily. I, I’m a firm believer in vitamin C, and actually, the scientists who discovered vitamin C also won the Nobel Prize for his discoveries. He lived to almost 100 years old and would take vitamin C every single day. High dose isn’t strongly recommended for the brain. And again, you know, he’s an ancient one. But I would say that there’s solid reason to take antioxidants on a daily basis. I take ginseng. I find it really helps me after like lunch time, because I do have the a little bit of energy, don’t, you know, kind of dip after, around that time. So I will take a little ginseng shot. It seems to be good for who would want to help for some women, especially women who had a history of TBI, traumatic brain injury, if anybody wants to know. Yeah, it’s quite common, I find I have it. So I think it’s a good tool to have. I drink a lot of green juices with aloe vera mixed in, and that really gives me a boost of energy. I drink green juices almost every day. Not too much because I know it’s it’s it’s a pity to lose the fiber, but I think it’s also a really good way to get a lot of vitamins and minerals in.
Gabby [00:42:11] Yeah. And do you like. I mean, and again, this is not you, suggesting these these are. I’m simply asking you what your practices. Yes. I like I take Omegas, as well. Do it. Do you. How do you feel about that?
Dr. Mosconi [00:42:28] Yes. I think it’s a really good thing to do for brain health. And then at least the research. On the brain that with brain imaging and the clinical trials that we have available, show that the RDA probably underestimates the amount of omega threes that are optimal in a person’s diet, because whatever they have, like on their website and their official documentation is like 1.2g per day. That might be fine from the neck down, but the brain needs more polyunsaturated fatty acids just to be able to renew the membranes inside the brain, which is key for synaptic activity. I also take omega three supplements. Yeah. So I think it’s really important, especially if you don’t really eat fish or don’t eat, don’t have a diet that is rich in omega threes because they hear a lot of people are like, well, I eat a lot of fruits and veggies and nuts and seeds like, yes, but try measuring that actually. And do maybe a blood test to see to check your levels. I checked my levels of nutrients at least once a year to make sure that I’m on track. With everything I do, the antioxidants, I do it the whole time. I’m sure you do it.
Gabby [00:43:43] Yeah, sometimes. And then, you know, sometimes it’s like, oh, I know that already. And then it’s been two years. So that’s, you know. Yeah, I’m, I’m never off that hook either. So a lot of times, you know, they talk about the brain and the gut being so closely connected and impacting and almost they’re almost like mirrors of one another in a certain way or, you know, kind of created from similar tissue and things like that. And the gut is so complicated, but it’s hard to ignore as far as like our overall health, our moods, all these things being impacted also by the microbiome is there are there things that you sort of see that show up that you go, yes, this makes sense to you as a scientist in the practice of good gut health.
Dr. Mosconi [00:44:27] Oh, yes, for sure, 100%. I think that, having good solid gut health is is extremely important for the health of the entire body as well as brain health, because it’s really inflammation is is a big issue for both. The rest of the body and the brain as well. And for women in particular, there’s one part of the microbiome that is called the astro balloon. To know if yes. So the struggle is a collection of bacteria, not good bacteria and some bad bacteria, but mostly good bacteria that are very helpful to regulate estrogen levels in the body because there are foods that contain estrogen in the form of phyto estrogen. So plant based estrogen. And then there’s obviously the estrogen to your body makes it needs to use the metabolize. And then get rid of at the end of its life cycle. And yes, problem is implicated. People believe in regulating estrogen levels throughout the body by also having an action on this hormone. That’s called sex hormone binding globulin. So it’s a protein, sex hormone binding globulin that determines the amount of free estrogen imbalance, the bound and unbound estrogen. And you really want them to be in a good balance throughout your body. So that’s one additional aspect of, gut health that is very often overlooked when it comes to women’s health. Right? So I think it’s important to realize the brain health is women’s health, gut health is women’s health, heart health is women’s health. We’re all working together in our body and in Western medicine. Counter decided to to split them apart. But no woman has that luxury, you know, to do that in your own body. They all work together. And it’s ridiculous that women’s health means going for a pap test. And that’s about it.
Gabby [00:46:29] Yeah, I really I even appreciate how you’re it’s like, don’t you know all of it. Muscle health. Like it’s all different this you know, the our bones, the way our ligaments and tendons work like it’s all different. And I really appreciate that distinction and the fact that there’s opportunities like this and people, you know, having access, to information that you’re putting out. So in, in “Menopause Brain”, you know, you shared that it’s, it is this long process and that estrogen is sort of the protect, one of the protective hormones of the brain and that it’s over a long period of time. So we sort of have established how people can, can be doing good practices to avoid that. Now, let’s say someone is sent that they’re late to the game, but they’ve been busy, they haven’t been paying attention. And, all of a sudden, you know, can you open the window is coming up all the time. You know, that’s my favorite. I love sitting with my friends. And then when they start doing the hand waving, I go, oh, here it comes. You know, what what are. So if she is okay if you’re not exercising and not eating well, start there, tighten it up, maybe get the blood work done. But is there anything else that she should be paying attention to if she’s kind of in this part of her journey?
Dr. Mosconi [00:47:50] There are a few things like toxins you mentioned before. So environmental toxins and pollutants are important because some are endocrine disruptors and could make your menopause worse. By all means, avoid passive smoke. I know that is not nearly as common were prevalent as it was the still. A lot of women either smoke or are exposed to secondhand smoke, which is just as bad for your ovaries. Yeah, it’s a cigarette. Yeah. Cigarette smoke is the number one ovarian toxin.
Gabby [00:48:26] I just had a thought of a woman telling her guy, can you put that out? It’s just not good for my ovaries, you know? So smoking is is gone out
Dr. Mosconi [00:48:36] Yeah. It’s one more reason we leaning away from it. Or if you if you are exposed and maybe you want to invest in an air purifier, it’s something, you know, if you really can’t avoid it, then it’s, it’s helpful to have a purifier just in case.
Gabby [00:48:52] And what others? How about alcohol? Everybody loves when I’m having.
Dr. Mosconi [00:48:56] I know I. I feel terrible about this, but alcohol can really have a negative effect on menopausal symptoms. It can make them worse. Especially the hot flashes and night sweats. And so many women feel like, you know, I haven’t been able to sleep and so tired and so stressed and just going to have a nice little drink and relax. And that might be true for the time being, but there’s a tendency to then wake up in the middle of the night because we don’t want two glasses of wine. And that’s, really, it’s, a little bit of a kitty. So I always say, maybe for every woman, you just be mindful of stimulants and see if they have a negative effect or not. It’s important to know, because even spices like chili pepper, that actually can make hot flashes worse for some women. And coffee. Can also have a negative impact not just in sleep, but also other symptoms. Amount of weight. So I am preparing for the transition to menopause and I love my espresso, but I just switched to decaf. I’m trying that because it is more for me is more the ritual of making the coffee and the flavor then the need for caffeine. So I’m trying this. Kevin, my husband was like, what are you doing?
Gabby [00:50:29] Is he Italian as well?
Dr. Mosconi [00:50:30] No, no, no, he’s from New York. Actually. He’s he was born in the Bronx.
Gabby [00:50:35] The other thing is, you know, about decaf, though, is you you want to do Swiss water, right? So. Because. Yeah, if you ask the caffeine out, you want to.
Dr. Mosconi [00:50:44] There’s a concern.
Gabby [00:50:46] No, no. So there is a good way to do it. It’s just avoid the ones where they’re using basically formaldehyde to get the caffeine out. There’s a process called Swiss water where they kind of pressure wash, if you will, the caffeine out. So that just to support that later. Does she need to. So she gets her hormones checked. She sort of sort of has a, you know, a come to Jesus meeting with herself about her lifestyle. You know, for me, I’ve never been a great sleeper. And then I, you know, starting many years ago, having children. And for me, magnesium, really has been, I never can say it right. There’s how many types of magnesium glycine? Eight, is the one I use before I go to bed. And I can honestly say that, it really helps me have a more restful, deep sleep. Or I didn’t wake up as often, and it was really, really helpful. So sleep is always going to be one even. I mean, I exercise, I eat well, I’m not having stimulants, you know, and anything like that past, past, almost noon, or we are, you know, dessert foods late or eating close to bed. I mean, I sort of among track with a lot of this stuff, but the sleep is always harder. I was mind grinding or worrying or doing whatever it is I was doing. So that really, was helpful. And I tried a lot of things, weirdly. And people I think when it’s so simple, like, oh, magnesium. But it really was.
Dr. Mosconi [00:52:14] I mean, it really, it can work. I hear that a lot. So when you when it was tested in clinical trials, magnesium did not show proof of efficacy. But let me tell you, those clinical trials in my opinion, are not really helpful because the way they’re done, it’s just not reflective, the reality of what women are going through. So I think if it works for you, you take it there’s no side effects as long as it’s in the right amount. And the performance may be valuable from woman to woman, but that just means you try it out. You know, it’s not a difficult thing to do. It doesn’t require a prescription or anything, so it just import. I think there’s a lot of do it yourself here when it comes to midlife. Like for me, when I can’t sleep, I, I’m trained in, in traditional Western science and the one thing that works for me for sleep is homeopathic. Yeah. Which I was like, I’m not taking this. And then friend was like, try it, try be open, mind it, it really works. And this, this thing that I was able to get Amazon, it’s like passionflower or some other herbs. Yeah. You know homeopathic formulation that’s I’m out, I’m out. It takes my stress away in like three seconds. I’m happy to I don’t know them. I have no conflicts of interest, but I’m happy. To share it later if you would like. Because for me, it works like a charm.
Gabby [00:53:43] Yeah. And I think we don’t give enough credit to tinctures and teas. I mean, there’s a reason these things and herbs have been around forever.
Dr. Mosconi [00:53:51] Yeah
Gabby [00:53:51] In “Menopause Brain,” you make it very clear that. And I’ve heard this a lot, which makes me very inspired. And wanting to support people is you’re not you don’t. It’s not. It wasn’t meant to be that you’re supposed to suffer through this change. Is it a change? It’s a huge change. You know, it’s about getting either with it, getting on it, getting ahead of it or, you know, sort of figuring your way out of where you are. But people, I think they sort of also mentally go, well, you know, I’m, I’m, I’m in midlife and this is just the way it is, I’m going to gain weight. I’m going to forget stuff. I’m not going to I’m going to lose my libido and really reinforces that. It wasn’t it wasn’t really meant. It doesn’t. That’s not really the sentence with this.
Dr. Mosconi [00:54:41] No, no, no. I think what’s happening with menopause has turned Western society has really conditioned all of us to only focus on the pitfalls that the symptoms of menopause are the only meaningful thing about this transition and that women become. Less attractive and not the interesting after menopause, which I think is ridiculous. Is it completely ridiculous? But what happens a lot? What comes up a lot is done for women living in Western societies. There’s no sense of accomplishment when it comes to menopause. There’s no sense a start is gained when it comes to menopause, which is completely unfair. But if you. Look at other cultures that own, not only that does not happen, and menopause is actually celebrated very often, but that correlates with having fewer symptoms or no symptoms. So there seems to be a cultural mindset component that I think we should really cultivate. All women on the planet, not just Western eastern. Where we need to realize that, yes, hormones play a big role, but your mindset does as well. And we know from history and from cultural studies and from anthropological studies that there are many societies around the world where women do not fear menopause. They just embrace it, just go along with it, and they don’t suffer nearly as much. Now, for instance, in Japan, they don’t even have a. Word for half lashes. They don’t have a word for menopause. That means the end of your cycle. You see how reductive this is? Menopause is just that you no longer have a menstrual cycle. You can’t have babies. That’s the door. In Japanese, the word to describe this phase of life is clean energy, which means rejuvenating, rejuvenation, or a new stage of life, a new beginning, renewed energy. And how wonderful is that? To think about menopause is something that happens that yes, there are pros and cons. It’s everything that has to do with having a reproductive system, but it doesn’t have to be the end of anything if it actually, if nothing else, menopause has has some upsides that we never talk about. Like more happiness. I was very surprised about that. But there are studies showing that women who are past menopause and generally happier than younger women who are not yet in menopause, and they’re also happier the day themselves, where we used to be before going through menopause. And that reinforces the notion that happiness has a little bit of a U-shaped curve, but that it really there is a little bit of a midlife slump, but then people are effectively happier and more serene, if nothing else. And then there’s this thing that so many menopausal women report, which is perhaps transcendence or, as our patients describe it, just giving fewer.
Gabby [00:57:47] Yeah, I was thinking the wisdom of not giving a fuck at all.
Dr. Mosconi [00:57:52] And that comes with liberation. And I think that it’s a combination of biology and timing. Right at that point. You know who you are, you know where you want. You know that you’re worth it. You’re not going to take any more baloney from anyone and just you’re not what you’re going to be doing, Minister. And there’s also a neurological basis for that, which is that the primitive parts of the brain that were so reactive in puberty actually turn down after menopause. So you’re less reactive to things that would driven you up a wall before menopause. You’re less reactive to negative things that happen to you, and therefore you’re able to sustain tranquility, if nothing else, for longer periods of time. And I mean, that’s not a gift.
Gabby [00:58:40] It’s I, you know, I’m 54 and I’m always like, oh, I must be getting a little smarter. But it’s just parts of my brain are getting turned down. Let’s face it. I mean, whatever. Listen, whatever.
Dr. Mosconi [00:58:50] You do and it is done for entertaining.
Gabby [00:58:52] But like, whatever it takes. So I just, I want to remind people hot flashes and brain fog can be minimized or geared down with exercise. You found that. You talk about it in the book. So I’m just driving that home because everybody also will say they have these symptoms, but then they’re not doing the things that they can control and pulling the levers that are available. So I just want to remind them and then stress, I mean this is a no go. So if we’re doing everything perfect but we’re highly stressed, this is going to crush us, in life, period, in all aspects of our life, whether it’s inflammation, gut health or in this case, menopause. So I just really want to remind them, of this. And I wanted to use you today to have a talk. And I really appreciate the way you did it, because I want people to have the science and the data. But I also appreciate the humanity aspect of this, because I think having the conversation and then kind of getting into, all right, well, what can you do? Is important because it’s. It’s having empathy that people are doing the best that they can. But, but there’s more. There’s more to do. So yeah. Thank you so much. I really appreciate.
Dr. Mosconi [01:00:10] It. You. Well, I appreciate you. Thank you. Thank you for having me.
Gabby [01:00:15] I have one last question, and it’s only because it just came to me. But I, you know, I’ve talked a lot about hormones on this, and I kind of wanted to utilize your expertise, around the brain and and. Yeah, I mean, I, I mean, you might as well, because you do talk about, you know, it’s an individual quest and it can be supportive for certain people and others. Actually. So you’re right. You are right. On this. If we’ve tried everything cause I thin it’s like, rather than going to the doctor and just getting slammed on on a another hormone therapy, I think it’s clean up your lifestyle, see how that goes, maybe get your blood work done, obviously, and see if you’re falling off a cliff. And then you, you tell me your feeling or your approach towards hormone therapy.
Dr. Mosconi [01:01:15] I feel like other women to know that it is an option. It is on the table. And I think so many women opt out. Not because they don’t want it or not because they wouldn’t benefit from it, but out of fear that they might get cancer or they might get some other diseases. And I would like to clarify that that is outdated information. That we have better research now, and professional societies have actually changed their take on hormone therapy, and that if you do it right, if you take the right hormones, at the right doses for the right amount of time, that is actually safe and effective for many women. Which is not to say the lifestyle is not. I think what’s important is to know they will have a range of tools and options that can be tailored towards every woman’s lifestyle. I am blessed, and I think you would agree with me that we have time to exercise. We have time to cook for ourselves. Maybe we have time to. I have time we met. You know what it is? We don’t have time. We make it. We prioritize the things. I know a lot of people who really struggle doing that. And in that case, I think it’s helpful to know that for eligible women, hormone therapy can also be helpful in that respect, especially for women who have very severe symptoms. And menopause is something I will look into.
Dr. Mosconi [01:02:54] For me, I’d much rather go the way you mentioned. I’d much rather really focus on my lifestyle. Yeah, but I never had have flashes. You know, I’m not in menopause yet, so I don’t know what awaits me down the road. So I want to be open with my options and just be sure that I’m making the right choices for myself that are safe and effective, and that I don’t like myself down for believing information that is not up to date.
Gabby [01:03:22] I really appreciate that distinction, because a lot of times you hear, well, if you have cancer in your family, you can’t do that and things like that. I actually personally, my testosterone got very, very low. And so and then I started having, AFib. Because a lot of times too, that sort of the thought was maybe the body by the end of the day has no more because the testosterone was so low that it was sort of working double time. So I did, in fact, for a while, very mildly supplement weirdly with testosterone over other things. And it was incredibly helpful. I am not opposed, to hormone therapy. Now, if someone’s listening and they go, well, we’ve I’ve had breast cancer, it’s still okay to get your blood work done. And, you know, sort of slow and low and kind of do things in a conservative way, right?
Dr. Mosconi [01:04:16] Oh, yes. Yes for sure. And another thing that is important to realize and so the guidelines have changed in this respect is that women who have a family history of cancer, but not the personal history of cancer, actually potentially eligible for hormone therapy. In my opinion, you want to be careful anyway. So it’s really important to have your own colleghi tree really mapped out with you. And then I see, I mean, that’s the first thing I would do is that I would round up my family and find out all the cases of breast cancer, what age they have and what was the outcome. And you go back in time as much as you can and as far and wide as you can with all your second degree and three degree ons and cousins and whatnot. And then you have an informed conversation with your provider. But it shouldn’t be, oh, there’s a history of breast cancer, maybe on the father’s side. Or is it right? And, you know, a third cousin. Triple time removed that it can be like that. It needs to be personalized and informed and based on data and not fear. That’s why I wanted to mention it, because there’s so much that’s been. Withheld from women. Just because the research is in there. Physicians are and, you know.
Dr. Mosconi [01:05:33] And I’m not really considering even hot flashes I’d consider a quality of life issue. It’s not the quality of life issue is not it’s not just discomfort. It’s an actual problem. And women suffer. And, you know, it makes me so upset. That menopause is one of the very few scenarios in medicine where suffering in silence is not only accepted, but recommended. And there really shouldn’t be. It should not be the case.
Gabby [01:06:06] Yeah. And I often even think sometimes because women are funny, right? They will do everything for everybody else, but not for themselves.
Dr. Mosconi [01:06:14] Yeah.
Gabby [01:06:14] So it’s like reminding them, like, actually you could do you’ll be more for the world if you take care of yourself. And we need calm wise, you know, women in our world and not ones that are silently suffering. So. So thank you for that. I just have a one quick question, which is, is there any observations about brains developing now? We have a full generation of people that have been on, electronics.
Dr. Mosconi [01:06:45] Yeah.
Gabby [01:06:46] Around the phone. I was just wondering if anything has jumped out from a neuroscience point of view or I know you’ve been busy and other things, but if there’s been ever, like, shoptalk, about either connection, length of ability to concentrate, I’m always fascinated to see if any of that is showing up scientifically.
Dr. Mosconi [01:07:08] I am not familiar with that work, but there is one thing I heard that is important. I think. And then thinking about the use of cameras where everything we do now, we take a picture. And children grow up being able to watch themselves do things in the past, right? Like, oh, look at this super cute video when you were two years old. Then do you remember when we went on vacation? Oh, really? Oh, here’s like 3000 pictures. So their brains can just never forget information. But there may be a reason why we don’t remember things from childhood, which is the. The brain is to let go of things. You can’t remember everything because that takes up a lot of space in your mind. Right? And so I’m curious to see what will happen to the memory circuits and networks of dids who have been constantly exposed to that. Yeah.
Gabby [01:08:11] I wonder so, Doctor Mosconi, if you have, you know, around the water cooler, talks with someone who’s in this, and it gets good. I want to have you back on. And, so the latest book is “Menopause Brain”. If people are interested in also brain, food and the brain. And I know you, I’ve heard you on something say, you know, I’m not that great on social media or places to find me, but you, you know, for people who want and are looking for you, can you can you just share with us all the places that we can find you?
Dr. Mosconi [01:08:43] Yes, I’m getting better at social media. I found that Instagram is a good platform for me. My very first experience was Twitter and there was shocking. There was complete shock because I can’t do this. I just cannot do this. But I like Instagram. I’ve been using it more, so it’s easy to find me there. And my handle is, doctor, Dr. Mosconi in Moscow and I in my website is Lisa mosconi.com. So that’s the easiest way to get in touch. And if anyone is interested in a brain scan, then it’s easy to just Google me and find our address. It was coconut medicine in New York City, were open to enrollment. And yeah, we’re doing well.
Gabby [01:09:26] It’s amazing. The work that you’re doing. And, I just appreciate your time today, and and, you’re just that thoughtful conversation. Thank you.
Dr. Mosconi [01:09:36] Thank you so much. Thank you for having me.