I just read an interview between Deborah Copaken and Dr. Lisa Mosconi that my friend Laurie Smithwick sent to me. I was not expecting it, but I am sitting on the couch shaking with sadness and anger and frustration. The interview is about the connection between Alzheimers and Menopause. Did you know a connection between these two exists? I had no idea.

Eight other things I had no idea about:

-Twice as many women get Alzheimers as men. If you’ve heard this fact before, you may have also heard it attributed to women living longer than men, but that’s false. I mean, it’s true that women live, on average, four years longer than men, but that doesn’t account for the massive difference in the number of women and men dealing with Alzheimers.

-Women’s and men’s brains age very differently. And for women, Alzheimer’s is not a disease of old age. For women, it starts in middle age.

-If a woman is going to get Alzheimers, the plaques will start showing up in her brain as early as peri-menopause, but she likely won’t get diagnosed because the tests were developed for men’s brains. From Dr. Mosconi: …a few years ago, [it was discovered] that the tests we were using to diagnose Alzheimer’s were not sensitive enough for women at the early stages because women score better than men on cognitive tests and always have. The cognitive score declines a bit with menopause, and then after menopause, but even women with a diagnosis of early Alzheimer’s may score better than men with the same diagnosis of Alzheimer’s.

-Taking out the ovaries or the uterus increases the risk of dementia in women. From Dr. Mosconi: It’s true. There’s a strong association between early menopause and an increased risk of Alzheimer’s in women. And oophorectomy, which is the surgical removal of the ovaries, increases the risk up to 70%.

-We tend of think of the brain as running the rest of the body, but other body parts have a huge effect on the brain. Like gut health. And our ovaries also have a huge effect on our brains.

-From Dr. Lisa Mosconi: When you lose your sex hormones — your estrogen and progesterone, FSH, all these hormones — the rest of your body starts aging faster. Your arteries harden faster, your bones become more fragile faster, pretty much anything that can age, ages a bit faster than before.

-Smoking affects men’s and women’s brains differently, and it’s harder for women to quit smoking than men. From Dr. Mosconi: Men’s brains and women’s brains are wired slightly different, in a way that the effect of smoking on dopamine activates different parts of the brain. In men, it makes you crave the effect of nicotine, but in women, it stimulates the brain centers that are involved in addiction. So women tend to develop a habit that becomes more psychological. It’s a habit. And that’s why the rates of successfully quitting smoking are higher in men than women. Because you can give men a patch and then you have the nicotine, and the brain is happy. But for women, this patch doesn’t help you with the ritual of smoking a cigarette. So it’s harder to break a woman’s addiction than a man’s addiction.

-Fun fact: Estrogen is the most ancient of all the hormones, and it goes across species. It’s even found in plants.


The interview is long (Medium estimates it as a 37 minute read), but it’s super interesting, and I hope you read it.

I’m not totally sure why I had such a reaction to it (I haven’t been touched closely by Alzheimers). I think I’m just mad that we know so little about women’s health.

I’m angry about the Women’s Health Initiative — it was started in 1993, and assumed every woman needed to take estrogen supplements as she hit menopause. The research did tons of damage to thousands of women so it was abandoned. But it was helping thousands of other women. Couldn’t we have dug into what was working and what wasn’t? I’m angry that the myth of the cervix being connected to sexual pleasure was only debunked in 2011. I’m angry that we didn’t get a 3-D model of the clitoris until two years ago. I’m angry that every test, every medical innovation, is developed for men, tested on men — then assumed to work equally well for women.

From Dr. Mosconi: Maybe at least we can change the bias that we have in health care and the fact that all the research that has been done so far, in all the medical textbooks, is based on the research of men. It’s either male cells, male mice, male animals, or men, and that leads to under-diagnosing women, misdiagnosing women, giving us the wrong drugs, and it’s just a disaster!

Did you already see this interview? Or have you had a chance to read it? I’d love to hear your thoughts. Do you suspect Alzheimers is in your future? Have you ever had that thing where you can’t remember a word? I experienced this the other day and it totally freaked me out.

P.S. — Two books mentioned in the interview that I want to check out:
Invisible Women: Data Bias in a World Designed for Men
– The XX Brain, Avery/Penguin Random House — it comes out in March 2020

My Alphabet of Menopause print by StudioKarenStanton.