Do you feel like your brain has been on a downhill spiral since you turned 40? You're not alone. The mid-life crisis is real, and it's affecting more women than ever before.
But there's hope! In this episode of The Hormone Prescription Podcast, we chat with Dr. Louann Brizendine about how to upgrade your brain at midlife and thrive.
Dr. Brizendine is a leading expert on the female brain, and she shares her insights on what's going on inside our heads during this time of transition. She also gives us practical tips on how to improve our cognitive function and protect our mental health as we age.
Louann Brizendine, M.D. completed her degree in Neurobiology at UC Berkeley, graduated from Yale School of Medicine, and did her internship and residency at Harvard Medical School. She has also served on both the faculties of Harvard University and University of California at San Francisco. She founded the Women's Mood and Hormone Clinic at UCSF. Her New York Times bestseller, The Female Brain, and its follow-up, The Male Brain, continue to be read around the world. Her eagerly anticipated book, THE UPGRADE: How the Female Brain Gets Stronger and Better in Midlife and Beyond, is out in April 2022. Now, as the Lynne and Marc Benioff endowed professor of clinical psychiatry at UCSF, Dr. Brizendine continues to speak, write, research, and consult.
In this episode, you'll learn:
What's going on inside our brains during the mid-life transition
How to improve your cognitive function as you age
Tips for protecting your mental health in midlife and beyond
The latest research on the female brain and how it changes in midlife
If you're ready to learn how to upgrade your brain in midlife and thrive, this episode is for you!
(00:00): In this episode, find out why the upgrade previously known as the transition is the gateway to the best years of your life.
(00:09): So the big question is how do women over 40, like us keep weight off, have great energy balance. Our hormones in our moods feel sexy and confident and master midlife. If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself. Again. As an OB GYN, I had to discover for myself the truth about what creates a rock, solid metabolism, lasting weight loss, and supercharged energy. After 40 in order to lose a hundred pounds and fix my fatigue. Now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results. And to give you clarity on the answers to your midlife metabolism challenges, join me for tangible natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kyrin Dunston welcome to the hormone prescription podcast.
(01:03): Hey everybody. Welcome back to another episode of the hormone prescription with Dr. Kyrin. Thank you for joining me today. You're gonna love my guest today. Dr. Louann Brizendine, I'm gonna tell you a little bit about her and then we'll get started. But first let me say, she's talking about the upgrade. What is the upgrade for women? Well, it used to be called the transition, which meant all kinds of bad things, bad outcomes, things you don't want for women, but she is reframing this time of life as being the upgrade. And I love that because it's really true. You are getting an upgrade, not a downgrade, despite what you might have been told or you've been led to believe. And she's gonna tell you how to maximize that so that this can be the best time of your life. Dr. Louann has some amazing credentials. She completed her degree in neurobiology at UC Berkeley.
(01:57): She graduated from Yale school of medicine and she did her internship in residency at Harvard medical school. You can't get much better credentials than that. She served on the faculty at Harvard and university, the E of California at San Francisco. She founded the women's mood and hormone clinic at USCF. Her New York times bestseller the female brain and its follow up. The male brain continued to be read around the world. Her eagerly anticipated book, the upgrade, how the female brain gets stronger and better and midlife and beyond is now out and available. She is the Lynn and mark Benioff and do professor of clinical psychiatry at UC S F. She continues to speak right research and consult. Please help me to welcome the brilliant I'm Dr. Louann Brizendine. Welcome Dr. Louann to the podcast.
(02:50): Thank you, Dr. Kyrin, nice to meet you and see you. And I'm just delighted to be here with your audience because you know, your people are my people <laugh>
(02:59): Yes, our people are the same. <Laugh> we
(03:05): Treat the, we treat the same group of patients. I do my medical center. They say Louann treats above the neck and we treat below the waist.
(03:12): Yes. I love that. But most people think that they're such a dichotomy there. Well, above the neck and below the waist, there's no relationship, but that's exactly what you talk about in your books is how connected our female hormones are to our brain function.
(03:32): Absolutely. I don't think people know that. I think, you know, once you hear it and you understand you go like the light bulb on your head goes, oh yeah, yeah, yeah. Of course the brain, the pituitary control all the other hormones in the entire body.
(03:46): It's so true. And the hormones in the brain and just all the intermixing, which I'm sure we'll get into how vital sex hormones are for cognitive function for brain function. But I wanna start just talking about your book, the upgrade, because I think this is really radical and I'm hoping you can explain to everybody, we always talk about the menopause transition. I actually talk about the menopause spectrum and how it's not a point in time, and you go through this spectrum of change, but talk about what the upgrade is and how it differs from the transition.
(04:24): You know, you and I speak the same language actually, because that's why I, with all my patients, I hated those words. Like the perimenopause menopause is cuz it's like, it's, those are medical diagnoses in a way. And they're just a little slice of what actually is happening. It's not the whole woman, this transition that we're going through from like about age, you know, 38 to 48 that we kind of call in the big brackets kind of AKA the perimenopause. Yeah. That's something that's happening just to kind of the, the ovaries and the follicles are, you know, starting to not be as healthy and they're starting to like die off and we lose them, but that's just, that's the medical diagnosis of that transition. So, but I called it the transition because it's, there's so much more that's going on for us women. There's all kinds of relationship, things, emotional things, things in terms of our work life things in terms of our children, that's like, there's all kinds of layers of stuff that's going on in our brain.
(05:14): So the transition, and then once you hit finish the transition, you go into what I call the upgrade and the upgrade, AKA menopause it's as you. And I know the definition of menopause actually lasts for one day, right? It's the day, 12 months after your last period is called menopause. It lasts for one day and then the next day you're in post-menopause. So, you know, it doesn't really, these words don't really kind of work for what we experience as women. And so certainly not what our women patients are experiencing. And it's so cool. I mean, once you hit the upgrade, they, after the rock and roll of the hormonal fluctuations of the menstrual cycle, the perimenopause, all of your fertility years, your brain circuits are and your body you're free of that, those waves that crash over you every month. And people don't realize that the hormones are changing, not just stuff in your ovary and your uterus, but they're changing all kinds of stuff in your brain circuits for your memory.
(06:12): Remember like three or four days before ovulation, it's a huge estrogen Sur just making you be, you wanna be kind of, you sway your hips a little more. You put a little makeup, it a little sexier. You know what you're doing is mother NA under the hood mother, nature's got you all wired hormonally to go out there looking for the best sperm. You know, those couple of days before ovulation, our sex drive goes up. We're all, you know, we're ready to rock and roll. I've got UA, our hips, actually our voice goes higher, all that stuff. We talk faster, et cetera. And then of course the PMs time comes, you're crashing. You know, you're having all of those irritability and those spurts of anger and tearfulness and my clinic, we call it the crying over dog food commercials sign, you know, we can Boohoo over anything.
(06:55): So the cool thing is, is that once you hit the upgrade, baby, that's gone and you've got all of this circuitry in there. That's working really well to just your dance card is open to add new things. You're not gonna have to struggle with your hormones being jerked around. You're not gonna be dealing with fertility hormones. You're not gonna be dealing with being pushed out there, looking for the best firm, whatever it is. You know, you've got all of this incredible space and brain power that comes and is able to like take on new project, new purpose women, lots of women, you know, in America, the biggest number of new businesses are started by women over 50.
(07:33): Yes. I always tell women that I work with that. I'm kind of sneaky. Cuz do I wanna help you with your health? Yes, but I'm really sneaky cuz I know you're sitting on gifts that you aren't using and you aren't delivering to the world cause you don't feel good. So if I can help you feel better, then you will get off your assets and give your gifts. And so I think it really aligns with what you're talking about. The upgrade <laugh> so many women see this as downgrade TBA, oh,
(08:08): That's wrong, wrong, wrong. That's no, that is so wrong. And this that's because society is still looking at it that way too. And where as these things start inside us, as soon as we start looking at ourselves as an upgrade, then society starts to follow along behind us. We have to take that for ourselves. We have to claim that territory, claim that for ourselves mm-hmm <affirmative> and it is an upgrade. And once women realize that and start seeing it as like, yes, your fertility years are over, but 50 women that are 50. Now many, a chunk of us will live to be a hundred plus you know, those women that are just starting in the early Perry, you know, a lot of those women will live to be, you know, 110, you know, there's, you've got more than half your life there. So you gotta, wow, you got this whole new chapter. I, I have a chapter in the book book that's called finding new purpose as well. I go through all the rock and roll of the, for women that are younger. I've had women in their thirties, they read this book and they go, oh God, Dr. Luann, thank you. I feel so much better. I thought it was all over when I was 40, you know, there's feeling so hopeful that there is more to it than just like things being, being over when you're 40 or 50.
(09:17): Yeah. And so what are the gifts? Why do you call it an upgrade? I get it. But I think there are a lot of women and men out there who aren't gonna get it. So what is new, better, special about this time.
(09:32): Okay. So let's go back to that jagged up and down of your hormones all during your fertility cycle, remember your brain circuits. So part of your brain circus was one of the little areas called the hippocampus, not the hippopotamus, but the hippocampus. You know, it's a really important area in your brain. If you stuck your fingers right in above your ears, by about an inch into your brain on both sides, that's where they live a little guys, the size of your, you know, your fingertips. But they're really important cuz it's the way you form all your memories. You attach your memories and it's a big memory cognition center in your brain. And every month the estrogen goes up and it sprouts like 25% different connections in that area. And then it gets all born down during the last two weeks when a progesterone comes and pours like weed, killer her on all those connections.
(10:17): So it's like building up, taking down, building up, taking down. So that's just one little area of the brain it's happening in other areas too. We don't know that we don't teach that or talk about it yet because the new technology is just being able to show that. So women need to know that that buildup tear down, build up, tear down. It's not letting you stand firmly on the shore. You stand more firmly and see further when you're able to just count on a more stable brain power every day of the month. You're not being jerked around by your hormones anymore.
(10:47): Yes <laugh>. And so you talk about all the benefits that occur. Like we're more relaxed. Our brain is more even chilled. Our moods are more even keeled. Now I know a lot of my people who listen to this podcast are wondering, well, Louann under Louann, are you talking about this is with hormone therapy or without cause they know me. They're listening to me all the time. And I always talk about why doing menopause naturally is a bad idea, the increased risk for disease and what I call midlife metabolic mayhem. And so help them understand, is this something that I'm gonna experience just naturally? Or is this something that I need hormone therapy to help me experience? How do I experience the upgrade?
(11:42): Okay. So I wrote this book and I had to stop tiptoeing through the tulips on this issue, right? Cause I was part of the generation where when women's health initiative came out in 2002 women's health initiative, you know, to stopped the hormones for all the women in the country. And I know you and I are seeing all these women now that have had these women that unfortunately went through this transition before we were back to being able to give women their hormones back, we see all kinds of problems. You know, they're getting osteoporosis and the Alzheimer's situation in terms of the actual evidence based medicine on that is being looked at right now. So we don't know some of that piece about the dementia, but a lot of the evidence is pointing to the fact that the brain needs estrogen too on going remember men, men don't fall off a cliff.
(12:26): Like we do hormones at that stage. They go on in a 60 year old man and a 60 year old woman. If she's not taking hormone replacement, guess what? Dr. K they have four times more estrogen in their brain than we do at age six. And, and that's why they have increases for prostate cancer. Yes, exactly. And that's what osteoporosis as much as women too, right? I mean, it's just basic biology. And once, you know, listen, biology is destiny, unless you know what it's doing to you. Yes. And once know, once you know what it's doing to you, then you can take appropriate action for yourself. So I tell women, they go, oh, why don't I get breast cancer? If I take hormones, blah, blah, blah, whatever the answer is, no women, the evidence shows that women in the five to 10 year of taking hormone replacement therapy after the change don't have any increased risk of breast cancer, unless you have the breast cancer gene.
(13:21): So I basically just test my patients, all their genes. I just test them to see if they have any of the breast cancer genes. And then you're in a different category. But if you're not in that category, then yes, you may safely take hormones after that period of time, that will help you get through that. Now, if you've had a hysterectomy, you're in the, you're in the lucky group, right? You're in the lucky group because you only have to take estrogen. You don't have to take progesterone because you don't have a uterus anymore. So those women in my practice are the happiest actually <laugh> that they don't have any have to take any progesterones. So the mixing and I talk about that in chapter three and four of the book, kind of the mixing and matching of the estrogen and the progesterone and different aspects of that.
(14:00): So yes, I really feel that that women should have the opportunity and doctors should not hesitate to, you know, women that are having difficulty sleeping. Remember the three pillars, right? The three pillars of your brain function, the three pillars of that little stool, three cord stool stool is only stable with three little legs. So one of the big legs is sleep for your brain, cuz remember, and that's why I bring this up in the context of pour my replacement there. Because if you're not sleeping, cuz you're sweating all night, you're up all night long and you're just like, your brain is erect. Now remember what happens in your brain? It's sleep is that all the little cells you've been talking to each other and your brain all day long, chat, chat, chat, chat, they're making all this garbage Gar they're called garbage proteins. They're just like, there's spewing trash around all over your brain.
(14:43): At night, those little neurons, they shrink down. They shrink back and they leave these little channels in between the cells where the whole body gets to flush out. They just come out with the hose and it flushes out all the garbage at night when you're sleeping. But if you're not sleeping those cells don't shrink back and you're not flushing out the garbage outta your brain every night. So that's one of the big deals about making sure you're getting good sleep during this transition. And lots of times, as you know, and I know it's like, gosh, a patient who's not sleeping. You put them on estrogen sometimes within a week, they're sleeping well again and their brain is clearing up from that brain fog that the other two little parts of the stool are of course having that Mediterranean type diet. So you keep your inflammation down.
(15:26): You keep your nutritional level up while your vitamins up and that extra corner of the stool. And of course the other one is muscles. Remember muscles, the big study on women at age 80, those 80 year old women who had the best cognition had the best muscle function, strongest leg strength, the strongest leg strength, and basically that leg strength and the muscles communicate with the brain. I tell women cuz one of the biggest muscles in our body is the butt muscle, your glute muscle. So I say one of the things I gave this little tip on TikTok and Instagram, that one of the best things for your brain is to do, but squeezes. So ladies, when you're sitting down at your computer, when you're standing, brushing your teeth or in the grocery line or driving somewhere, do your butt squeezes. If you aim for a thousand a day, that's good. I figure if I can do, if you can do a hundred a day, that's good. Keep the muscles going. Cuz the muscles release things into your bloodstream called Mykines that stimulate the brain as well as the whole nervous system that stimulates the brain. So that talk back and forth study just came out last week in the new England general showing people's muscle strength is really a big prevention of dimension. So those are the three, three little stool. Just the little legs on the stool is the sleep, the diet and the muscles.
(16:37): Okay. Super important. And that's one of the reasons why I think testosterone is so important to maintain that muscle mass, because like you said, it's related directly to brain health
(16:47): Cuz I think that's come up a lot with women and you know, of course all of us, it's not FDA approved in the United States, but the European women have had it for 20 years. European women have a, a compound that just comes in a little like little pump that you pump out one pumpy you run it on your wrists and that's your testosterone supply for the day, but we don't have it here.
(17:04): Well we have bioidentical compounded hormones and I'm a big believer in test don't guess. So test the levels and optimize to optimal physiologic levels using a custom compound prescription.
(17:21): Yeah, but we talk a lot about with men that they lose muscle mass, their dopamine goes down, they feel like they've lost their edge when they go through cuz their testosterones going down. But the same things happen for women too. And really in America we only talk about testosterone as it relates to women's sex drive, but it's about so much more it's about brain health and neurotransmitter balance and muscle mass. So it's, I think it's super important.
(17:49): Yeah. I think that it has to be individually tailored made to each woman because I have, I've had a lot of women that you know, that the downside is that you get a little bit, you get more irritable, it's easier to have it's even for women to have road rage road rage on testosterone.
(18:04): I think, yeah. If it's too high, you can definitely have that. But if you get that sweet spot, I mean we, women have testosterone throughout our lives and most of us don't have a problem with it. So if we can get it at that sweet spot that's right for each woman, then I think she doesn't have an overabundance of aggressive tendencies or anything like
(18:24): That. The DHA can sometimes be okay for some women as long as they don't get acne from it, you know?
(18:30): Yes. Okay. So those three pillars I know in the book, boy, you go through so many things. I don't know which to ask you about first <laugh> let's talk about dementia. So I recently did a, a Ted talk and I, I talked about my mom who has all advanced Alzheimer's and really the only risk factor she had was she had been menopausal without hormone therapy for three decades. And so that's probably her biggest risk. And so hormones are a part of that, but what are other ways that people can fend off dementia, increase longevity and wellbeing.
(19:07): So those studies are really being done. And I think that the estrogen replacement, one of the things we look at that why women have more than men is first of all, of course, women live longer, but you know, not that much longer, like, you know, we're at three or four years longer and that's about it. So, but women, for some reason do have more dementia. I have some of my colleagues who are specialists in Alzheimer's and they really think that that women at the transition should definitely be taking estrogen replacement during this transition to help keep their brain active and functioning. So there's just so many receptors in the brain that for estrogen estrogen receptors, like if you just looked at your, you took a picture of my brain right now with like a special filter that just showed you the estrogen receptors all over men, it would look like the United States with a massive COVID outbreak.
(19:55): You know, they'd be like if they little dots everywhere, you know, cause estrogen receptors throughout our brain and obviously our body too. So that is one thing I suggest for women, the dementia also inflammation. So we think of that inflammation. I talk about this in the book I talk about in the, I have a chapter that's called, you know, the neuroscience of self care and that chapter chapter six and also chapter 14 specifically talks about keeping your brain healthy and avoiding dementia. And besides the estrogen replacement, there's all kinds of things about inflammation and inflammation does not just mean an infection. We always kind of think of it as meaning an infection, but there's a lot that we're learning about. What's called it's a really little technical turn it's called sterile inflammation. It basically means inflammation without an infection. And that happens in our body all day long all the time.
(20:43): And we need to clear out that inflammation all the time. So things like the Mediterranean diet and things like just basically trying to keep all of your vitamin levels at the right level is really very helpful to keeping inflammation down. So anything that you can do, keeping your microbiome and your gut healthy, which is basically comes from eating really healthy fibers. I mean, you do not need to take a handful of probiotics every day. I mean, some people like to take those, but sometimes, sometimes those cause a lot of trouble for people who have small intestine problems and larger intestine problems taking too many probiotics can be a disaster, but some people it can be okay for others. But keeping your microbiome healthy basically comes from eating healthy fibers in your diet, you know, both the soluble and the insol