Subscribe
Share
Share
Embed
Neuroscientist Lisa Moscone discusses the evolutionary reasons behind menopausal brain transformations, emphasizing resilience and complexity. This episode covers brain function shifts, the grandmother hypothesis, and the impact of hormone therapy on brain pruning. Along with Dr. Mindy, Lisa stresses the importance of research on menopause's mental health implications and advocates for personalized menopausal toolkits. They also highlight the benefits of a plant-forward diet, fibre for hormonal balance, and the influence of estrogen on brain health.
To view full show notes, more information on our guests, resources mentioned in the episode, discount codes, transcripts, and more, visit https://drmindypelz.com/ep234
Dr. Mosconi holds a PhD degree in Neuroscience and Nuclear Medicine from the University of Florence, Italy. A world-renowned neuroscientist, she ranks in the top 1% of scientists of the past 20 years by official metrics. Recognized by The Times as one of the 17 most influential living female scientists and honored in ELLE 100: Women That Are Changing The World, Dr. Mosconi has been acclaimed as "the Mona Lisa of Neuroscience" by ELLE International.
Check out our fasting membership at resetacademy.drmindypelz.com.
Please note our medical disclaimer.
We were taught that doing anything "like a girl" was a weakness. Dr. Mindy Pelz is here to prove it's your greatest strength.
A renowned advocate for women's health, Dr. Mindy is passionately committed to helping women embrace and trust their body's natural healing processes. Drawing on an extensive background in women's health, she's developed groundbreaking, science-backed approaches that help women work with their hormones, not against them, through every stage of life, from cycling to perimenopause to the wisdom of the years beyond.
On Live Like a Girl, Dr. Mindy helps you come home to your own body. Every Monday, she sits down with some of the brightest minds in health and wellness for honest, meaningful conversations that hand you the knowledge, tools, and science to do health your way. No more pushing through, gaslighting yourself, or shrinking to fit. Just permission to live in rhythm with the body you were designed to have and to finally feel at home in it.
Press play, and let's live like a girl.
Dr. Mindy Pelz: On this episode
of The resetter podcast, I got a
crazy treat for you. I have
brought you Lisa Mosconi. And
this conversation for all of my
perimenopause, menopause and
postmenopausal friends out
there. This is the brain
conversation I've been dying to
bring you. So let me tell you
who Lisa is and what you're
about to hear. So, hopefully
you've heard of Lisa, but if you
haven't, she has written the xx
brain. And Her most recent book
is called the menopause brain.
And she is a neuroscientist and
she is in deep with research
specifically around all aspects
of the female brain. The most
current research she has been
doing is on the menopausal
brain. So I have been dying to
bring her to you all to really
dive into some key helpful
pieces of information we can all
use to navigate this crazy brain
experience that many of us have
as we go through the
perimenopause and menopausal
journey. So with that said,
here's what you're going to
hear. So for starters, we talked
about three major times in a
woman's life where there is a
neuronal pruning that happens.
What that means is that the
brain actually starts to get rid
of what no longer serves it, and
a new brain is formed. So we
many of these three times of
life will be familiar to you.
It's puberty, pregnancy, and
perimenopause. But what is
fascinating about what Lisa and
I discuss in this is that when
you look at puberty, there's a
very specific reason the brain
needs to prune itself and grow
bigger. We talk about that. When
we look at pregnancy, same
thing, very specific reason we
need to do away with some of the
neurons that are weighing us
down so we can tap into being
able to take care of children,
we talk about that. But here's
where it gets really fun, is
what is the primal reason that
the menopausal brain needs to
prune the old and grow a new
brain. And that is the part of
convert this conversation where
this gets really interesting. So
if you want to make sense of
what's happening to your brain
as you go through menopause,
this is the episode for you. In
fact, I love it so much. I hope
you share it with all your
menopausal friends. If you're
also asking like, what do I do
about HRT, Should I do it?
Should I not do it? We discussed
this in a very balanced
conversation. I loved that part
of the conversation. And then we
dove into diet, what diet is
best for the menopausal brain.
And of course, we landed on
fasting. What does Lisa think of
fasting and ketones and its
experience to the menopausal
brain? Phenomenal conversation.
This, I bring you this was so
much joy. I hope it gives you so
many answers. And please share
this out because this is what I
have been trying to synthesize
and bring to women for the last
several years. And we just
nailed at least an eye in this
conversation. I'm so excited for
you to hear. So Lisa Mosconi,
the menopause brain. Enjoy.
Welcome to the resetter podcast.
This podcast is all about
empowering you to believe in
yourself. Again, if you have a
passion for learning, if you're
looking to be in control of your
health and take your power back,
this is the podcast for you.
Gosh, I have so many things that
I personally want to say to you.
For starters, the xx brain. I've
read that several times. It was
one of those books that as I was
going through my Peri menopausal
journey, I was just trying to
understand why my brain was
thinking different. And even
though so much of that book was
geared towards women of all
ages, it was like the only
resource we had at the time. And
it actually took the xx brain
actually took I went from my, my
what you taught me in that book
to PubMed, and I started just
looking into PubMed and I was
like, Okay, well what about what
happens when estrogen goes away
to the brain and what happens
when testosterone and
progesterone and I started doing
all my own research, which I
want to talk through with you
today. But I also then when I
saw the menopause brain came
out, I was like, Thank you,
Lisa. Thank you because we
needed a more a deeper
conversation specifically around
the menopause brain. So that's
my intro to say that I am I'm a
total fan and I'm so so excited
you wrote this book. So let me
just say welcome. And thank you
so much for putting the time and
effort into this book. We really
needed this.
Lisa Mosconi: Thank you. Thank
you so much. I so appreciate it.
When I wrote my very first book,
brain food, everybody wanted to
talk to me about Alzheimer's
prevention. So then I wrote the
xx brain, which is really about
Alzheimer's prevention in women,
and what everyone wants to talk
to me about with menopause. Yep.
And so now, I know that
everybody wants to talk to me
about the mommy brain, pregnancy
and mothers. Oh, yeah, daddy
prespray. Now, this is so funny.
And if you want we can talk
about this more later. But I'm,
who was speaking with Gabby
Reese, it wasn't her podcast.
And I just said something to
her. Just anecdotally, I thought
that we're just doing like an
either warm up conversation. In
this snippet is like a 20
seconds thing about how women's
brains change in pregnancy and
with motherhood, just went viral
with almost 2 million views.
Wow. And it was like, Oh, my
God, this is something I just
that kinda like
conversationally, and I wish I
did that. I wish I just had more
time to elaborate more. So maybe
we can spend a minute on that at
some point.
Dr. Mindy Pelz: Did mommy brain
in the menopausal brain are both
massive shifts in hormones? So
they, they, they I would think
they act very similar. Yeah. You
look at it. Yeah.
Lisa Mosconi: So that's not the
fun fact that shared with her.
But yes, we are now looking at
similarities between menopause
pregnancy and puberty. Yes, not.
Because these are all pivotal
times in a woman's life that I
referred to in the books if the
three P's right puberty,
pregnancy, and Peri menopause,
during which brain aging or
brain development is
substantially impacted, and
progresses in ways that we don't
usually associate with aging,
where, when you think about
brain aging, I think we're all
familiar with those kinds of
graphs, where you see that when
you're 3035, everything is great
and flat, basically, the curve
is the neuron density curve is
flat, and after 3540 is a slow,
gradual decline in the number of
brain cells in the we have and
then for some people is faster
for some people is gentler,
forget it, if you're a woman,
that kind of model is almost
100%, based on studies done on
men, were there brain aging is
actually quite gentle and
linear. But if you look at the
way that the female brain, a
woman's brain changes throughout
the lifespan is way more
complicated than that, because
as soon as we hit puberty, or
brain gets in sync with the
ovaries, right, this connection,
the neuro endocrine system gets
activated. And from that moment,
on, every time the ovaries
cycle, the brain micro cycles,
right, there's nothing flat,
they're just like little waves
throughout your entire
reproductive life. And then once
you get pregnant, there is an
over activation of this system
that then is followed by a
little bit like a crash and burn
postpartum. When the brain goes
through a massive remodeling,
when some parts of the brain
lose volume, and shrink in some
other parts of the brain
actually gain volume in gaining
increasing connectivity. So it's
not linear. It's more like a
tornado. Right? Every time a
woman gets pregnant, and then
there's menopause. That's
another major turning point with
another little tornado, and then
cellular aging.
Dr. Mindy Pelz: Big. Can we call
it a little bit bigger than a
little? Like a hurricane? And
major? Yeah, there's some. Yeah.
Lisa Mosconi: It's more like a
breeze. And for some women can
be really massive. But then when
you look at the whole
trajectory, there's nothing
linear about it. It's very
complex. And we never talk about
this complexity. And you know,
we never give women credit for
navigating this inherent
complexity, making through it
and taking care of everybody
else at the same time.
Dr. Mindy Pelz: So you know,
what's interesting, thank you
for saying that. And then one of
the three lines that I read in
your book that I just love is
this compassion for ourselves.
And one of the appreciation
Yeah, one of the things I've
noticed about women is that when
our health goes off, we don't
tend to blame the people around
us. We turn on ourselves. Yeah,
and we blame ourselves. And this
is why I think discussions like
this books like yours are so
important because all of a
sudden a woman sees herself. And
she's like, Oh, I'm not alone,
oh, this way that my, my brain
has been thinking is actually a
hormonal shift. It's not because
I hate my job, or I hate my
kids, or I don't want to be with
my partner anymore. I mean,
those can be like situations.
But it's, I think giving
language to these brain changes
is really interesting. The thing
that I find fascinating about
these three P's is that each one
of them, there is a primal
reason the brain is doing what
it's doing. And when you look at
puberty, and you look at
pregnant pregnancy, or
postpartum, you come out of
those initial experiences. And
that's like, the brain has to
function in a heightened way to
be able to adapt to the new job.
Postpartum is a great example,
when you said, Oh, it's switch,
all of a sudden, there's new
neuronal growth and other parts
of the brain. It's like, well,
yeah, that makes sense. Because
you need to be able to use your
brain in new ways to be a
mother. But in menopause, also,
I don't. Okay, so that's, this
is the root of one of the major
questions I have for you, is if
we have this hormonal shift,
which is also followed by a
potentially by a
neurotransmitter shift that I
want to talk to you about, what
what is the upside? Where's the
brain going? As these things are
shifting? And what are the new
things that are coming online
for the menopausal woman? And I
think if, if we understood that
we could weather the storm a
little bit better? Yes.
Lisa Mosconi: And I loved it,
you're interested in that part.
So when I was writing the book,
I had this super long part about
puberty, pregnancy and how they
really help menopause makes
sense. And then I thought, Oh,
everybody always says that. I
overdo it with the science. And
so I showed them in short, and
they but Oh, my God, I love that
part so much. Can I can I
elaborate up?
Dr. Mindy Pelz: Yeah, give it to
us. Now, I love this. Yeah, this
is like
Lisa Mosconi: 100%
neuroscientists take on
beautiful women's brains as we
go through reproductive changes.
So what happens at puberty for
both boys and girls, is that the
connection with the reproductive
system turns on, and it is
important to realize that the
major drivers of evolution are
having sex and having children
and being able to feed yourself,
right. So a huge part of your
brain is actually wired to
respond to reproductive health.
This is just evolutionarily
sound information, because we
know that there's a huge part of
the brain that is network with
the reproductive system. So a
puberty, humans are supposed to
start having children, or at
least are able to start having
children, right. So you can't
still be a kid, your brain needs
to switch and prepare for the
new job with the new job is
allowing you relatively young
human, to not only become
apparent, possibly, but also to
become a member of society.
Because humans are not
particularly strong animals in
some ways, right? You have to
fight and hunt is a team. And
that's really how the human race
survived is by bonding with each
other and sticking out together.
So the brain rewires itself in
two ways. Number one, there's
pruning, there is a huge amount
of pruning the play with almost
50%, almost half of all your
neurons are gone. The brain just
says this is my biological clue
to get leaner and meaner, if you
will. Why is that important?
Because neurons are extremely
expensive to carry. So as the
brain Yes, so the brain is the
most metabolically expensive
organ of the entire body takes
up a huge amount of energy and
resources, not just to make it
work, but also just to have all
those brain cells. So if you
don't need them, it's best to
get rid of them. Now, what kind
of brain cells you don't need
anymore? Plenty because at this
point, you can tie up your
shoes. You can make your own
food, you can find your way
home, you can ride a bike,
right? All these little neurons
that were responsible for
encoding every little step of
the way. Those are not needed.
Because at that point, you can
do all these things in
autopilot. Yeah, so the brain
can just get rid of all this
stuff, you know, as a spring
cleaning, I don't need it. Let's
give me the then. And now let's
put all our energy and resources
to Words, reassembling to notice
that we're keeping to make them
stronger and better connected.
So if you're a brain, you want
to actually be a little bit
smaller, but more dense, you
want to have a higher density on
neurons inside the brain. What
part of the brain is rewiring
and getting stronger? This
theory of mind network, these
various special network that is
involved in developing social
cognition mentalizing,
developing empathy and the
ability to put yourself into
another person's shoes. Right.
So for girls, this remodeling
happens a little bit earlier on
in life around age 1112. As we
hit puberty, for boys, it takes
a little longer around age 1415,
which many people say this is
the neurophysiological correlate
of the fact that girls tend to
mature neurologically a little
bit earlier than boys, then the
brain keeps growing. But all
these changes that take place
are really the mechanism by
which your brain allows you to
become an adult. Now, this
process is wonderful and is
really the key to keeping
society alive. However, it's not
painless, right? Every time the
brain rewires itself, there may
be consequences. This became
motions, rather reckless
behavior. All this drama and
finances go through, I would say
all day, the weakness and the
brain fog, and the sweatiness
there are a lot of neurological
sciences, psychiatry,
psychiatric symptoms that are
correlated with becoming an
adult with puberty in other
adolescence. Fast forward to
pregnancy, which obviously only
women go through incentive
really similar happens in other
time, so the brain sheds
neurons, which is getting rid of
a lot of gray matter, not a lot.
I mean, relatively speaking,
there's some gray matter loss,
which, in my opinion, is another
clue to let go of a bunch of
stuff you no longer need.
Because at that point, you'd
like to leave a bit older, you
need to make room for becoming a
mother. So the brain rewires
itself another time in once
again, this theory of mind
network gets an upgrade in the
same place is the same nice,
yes. So the reproductive system
is always connected to the same
parts of the brain. Right? Okay,
the theory of mind network is a
really important one. And then
there's the cognitive estrogen
net. So both these parts of the
brain, which is huge, and the
brain really changed together,
every time we go through these
transformations. And so,
pregnant women, especially after
the baby's born after
postpartum, there's a reduction
in gray matter, but the
strengthening of some other
parts of the brain that the
theory of mind, because now you
really have to rely on your
intuition, you literally have to
be able to read minds, because
that baby will not speak to you
coherently. But a really long
time. Uh, you need to make sure
the baby survives, you need to
protect the baby from danger,
you have to feed the baby, you
need to function on those leap.
So there's a lot that your brain
needs to be able for you to do
for you to succeed. Right. So
once again, there's the upgrade,
there is the supermom brain,
yet. There's also baby blues.
There's postpartum depression,
there's sleeps with night,
there's brain fog. There is
confusion, there's reduced
focus, right? All the things
that we associate with the mommy
brain, usually in a negative way
without thinking what but look
at all the things that you can
do now. Yep. Right. Right. And
fast forward to menopause,
again, is the same brain
network. But what happens now?
You're done having children. You
don't need all those neurons.
They weren't responsible for
having a menstrual cycle. They
were responsible for hosting a
pregnancy, they were surprised
that they were making you the
super intuitive mom. So it's
possible that the brain just
shuts those neurons again, just
another pruning going on. And
then the brain revived rewires
itself another time and we this
is not published yet. But we
find evidence that connectivity
in the brain is increased after
the menopause transition in some
parts of the brain this time
more frontal. So it's more
plenty Aha, yeah, it's more
about planning is more about
being rational. Yes, it's more
about being in control. So less
impulsive, less reactive, more
stable, more centered, more
grounded. And if you think more
empathic, there's another boost
in empathy. And there's a
there's a boost from, we would
say, emotional transcendence,
you would probably say given
fewer. F. But yeah, you
Dr. Mindy Pelz: can say you can
swear on this podcast, you get
you do, I can tell you as
opposed to menopausal woman, you
do get give a lot less fucks.
Lisa Mosconi: This comes up so
many times. Yeah, with everyone
we talked to everybody is that,
you know, I just don't sweat the
small stuff anymore in the org.
But it comes up all the time.
And I think it's such a blessing
in so many ways.
Dr. Mindy Pelz: I think that was
so beautifully described,
because I now where my brain
goes, is so then what is this
the purpose like with with
puberty, the purpose is to
become the way I interpret what
you said, the purpose is to
become a higher member of the
community, like a more higher
functioning member of the
community, with with postpartum,
the purpose becomes to have this
really good intuitive sense for
your baby. Okay, so if all of a
sudden there's another pruning
that's happening in menopause,
and now all this upside comes
in, what is our purpose? And
specifically, what is our
purpose in relation to the
cultural society?
Lisa Mosconi: Yes, so there are
theories where all these changes
are really in place to support
women to transition from being
reproductive, to be non
reproductive, but remaining
highly productive. In the best,
the best theory is the
grandmother hypothesis.
Dr. Mindy Pelz: Ah, yes, right.
Exactly. That to everybody? Yes.
So
Lisa Mosconi: I find it to be a
beautiful, beautiful theory, at
least not everybody buys into
it. But I think that the
premises, the neurophysiological
premises are sound in the
genetics or sound up to explain
it. So the grandmother
hypothesis was developed by Dr.
Hawks, Kristin hawks, where she
was studying the hartsdown, a
tribal community. And she was
really interested in dispelling
the myth of men, the hunter,
because she was saying, Well,
look, when men go out hunting,
more often than not, they
actually come back with nothing,
they come back empty handed,
right. So it Dougie isn't
bringing back the bacon, who is
who is taking care of the babies
and the elderly and everybody
else. And it turns out, it's the
women. Yes, they're foraging.
But that's really what provides
the vast majority of sustenance
for the entire community, most
of the time, not always, but
most of the time. But then she
went a little bit further, she
kept studying these, these
women. And she realized that
once the younger women started
having children, the older women
who were past menopause, they
just stepped in and started
taking care of everyone
everything. So they will do all
the foraging, they will take
care of all the grandchildren,
they will effectively raise the
leader ones, so did their own
daughters with daughters in law
could keep having children
themselves. So effectively, they
stepped into a leadership
position that was only made
possible by their boss being
postmenopausal. Because at that
point, there was no competition
for reproductive fertility,
daughters. And also they will
not risk dying by keep getting
pregnant at older ages. So in a
way, that was a win win
situation, that is actually
really interesting to me as a
scientist, because it goes
clearly against Darwin's theory
of evolution, which again, was
developed by men based on men,
right, where you're saying the
only purpose of being alive on
this planet is to pass your
genes on to the next generation.
This is only true if you're a
man, right? Because men are
fertile into their 70s and 80s
sometimes, but for women that
will be extremely disadvantaged,
there will be an extreme
disadvantage. And so I started
to think well, what if nature is
actually not as misogynistic as
those were writing about it?
Because look at this present,
right? If you look at this
process, yeah, from, from a
female perspective, it makes so
much more sense to start so much
being reproductively viable at
some point and remain alive, so
that you can just enjoy the rest
of your life but also being
effectively taking care of
everyone.
Dr. Mindy Pelz: Right? Oh my
god, okay, you just answered a
three year quest that I've been
on to figure out why the female
brain changes the way it changes
during menopause. And one of the
things that fueled me even more
is I brought Dr. Amen onto my
podcast. And and I trust his
opinion. And I asked him, I was
like, tell me why we have this
massive change in hormones. And
I want to get to
neurotransmitters here in a
second. Why does the brain go
through this in the peri
menopausal years? And what is
the body up to? And his response
was, oh, you weren't meant to
live as long as we're living
right now. Right. So that made
me so mad, because I was like,
so wait, were we supposed to
just be tossed aside once we
stopped reproducing? But I
couldn't answer the question of
what happens to the brain for
the good. Like, where does the
brain go when you get on the
other side of the peri
menopausal process? And you just
said it so brilliantly. And that
needs to be every woman
listening needs to understand
that's where your brain is
going? How many how much
suffering would be helped if we
knew that was the brain, the
brain is no is training for a
leadership position in the
culture?
Lisa Mosconi: I love that.
That's right. It's so beautiful.
It's training for a leadership
position. Oh, my God, I love
that. Yes, it's beautiful. And
look, what he mentioned is the
opposite theory is called the
mismatch hypothesis. Okay, a
menopause that is 100%, derived
from Darwin's theory of
evolution, and was really what
everybody thought menopause was,
until the grandmother hypothesis
and some derivatives started
being formulated and confirmed
and replicated and whatnot. The
theory was, and this I think, is
very important to recognize
then, if you are born with
ovaries, the idea of going
through menopause is a no
brainer, right? We just now that
at some point, the ovaries will
start with stop ovulating and
then we're going to go through
menopause. But in reality
menopause isn't is a major
biological Riedel be because we
do. Yeah, riddle is, it's a
puzzle. It's a big question
mark.
Dr. Mindy Pelz: It feels like a
riddle when you're going through
it. Yeah. Oh, yeah. So
Lisa Mosconi: for sure. But this
if you just look at biology,
most female animals do, in fact,
die. Their lifespan coincides
with a reproductive span, but
not for women. And women are one
of very few species on the
planet animal species who are
who have evolved the ability to
live past menopause. So the only
other species are some whales.
That's killer whale. Okay,
norwall. Another type of whales,
one type of the Asian elephant,
one type, when, perhaps one type
of giraffe. And then a little
bug is called the Japanese a
fit? For whatever reason,
obviously doesn't mean straight,
but is able to outlive
fertility.
Dr. Mindy Pelz: Yeah, what? What
are the reason why though? Why
are there only a handful of
species that that have this
function. And
Lisa Mosconi: well see, it just
sticks to evolution into an
adaptive quality, because it's
really hard to leave without the
super powers of your hormones.
So there has to be a big
adjustment that takes place
where your entire body and brain
is able to find a new way to
function that does not include
estrogen, progesterone, and to
some extent, testosterone, but
switches to alternative routes.
And there is a big
accomplishment in the thing when
people say you were supposed to
die after menopause. And it's
only that modern medicine and
technology is keeping us alive
for longer than nature intended.
Then thinking no real. I mean,
perhaps but the reality is that
this kind of evolutionary
changes take a really long time.
Yeah, to a core and it's every
woman on the planet. So this
cannot have happened in the past
50 years. There must be
something genetically that is
more Ancient, yes, that is being
perhaps pushed or boosted by
improvement in health quality.
Of course, that will play a role
as well. But it can't be the
only reason there has to be
more. Because otherwise, it just
weird. I mean, I think
genetically, it would be a
little bit too quick of a
change. Yeah.
Dr. Mindy Pelz: Okay, so that
leaves me to two questions. One
is, I know, this is like, you
have no conversation I've been
dying to have and you're just
you're, you're sparking so many
answers for my curious brain.
Good. So how long as this
pruning process supposed to take
when you're in menopause? And is
there a way to speed it up? And
what happens if all of a sudden
I start putting patches and
creams and turkeys and pellets
and I start manipulating the
system with an exogenous source
of hormones? Does that change
what is supposed to naturally
happen, which is what I now I'm
going to think about is a
pruning so that you can be take
on this cultural leader position
that we are meant to be in.
Right.
Lisa Mosconi: It's a wonderful
exercise. So these are two
wonderful questions. So the
first answer is that we're
looking into it. Okay. In 2017,
we published the first study,
brain imaging study, looking at
women going through menopause
2017. The first it's not so
offensive, is a woman, I think
it's ridiculous.
Dr. Mindy Pelz: I Oh, it's
offensive, because we've never
looked at a woman's brain this
way. We've never done it before.
Lisa Mosconi: How is that? How
is that even possible? Every
woman goes through menopause.
And it just was not been studied
using at least using brain
scans. But I think I think the
brain, you know, it's one of the
most important organs that we
have. And more than 75% of
menopausal women really have
neurological symptoms, from hot
flashes and night sweats to
brain fog and memory lapses. So
I was like, well, so many people
come to us so many women will
come to us for our studies. And
for the Alzheimer's prevention
clinic, I need to be able to
give them an answer. So I went
and said, what's been done? You
know, what do we know about the
menopause brain? And the answer
was basically nothing. All the
studies that were done, there
weren't that many studies to
start with. In all the studies
were done after menopause, but
after by a long shot that women
were low 70s or 80s, or late
60s. So we started looking into
that. And so far still today,
this is what 2020 For our
studies. Thank goodness, I
remember our study that the only
studies that look at women over
time, using brain scans. In will
okay. We again is like geez, can
we just kind of make this a
priority? Please?
Dr. Mindy Pelz: Agreed, because
it's it's such a dramatic brain
change that until you actually
go through it. You can't put
words to it. I mean, it's very
difficult to explain. I
Lisa Mosconi: completely agree,
I completely agree. And now
we're looking at all different
aspects of this transition. And
what we find is that the brain
starts changing before the final
menstrual period, during Peri
menopause, or to the menopause
transition, women go from having
a period to not having a period,
that is the most intense phase
for brain rewiring and
remodeling, then there's still
changes as far as I can tell
them this, there are still
changes for about six years
after the final master that
here, and then it depends, we
see and we obviously needs to be
replicated, but at least we know
something right? So what we see
is that for some women, the
brain eventually these changes
can slow down. And then they
kind of plateau. For some women,
there's a little bit of a
rebound. So you see more energy,
you see more cellular energy
production, you see a little bit
of more even more volume in the
brain in some parts of the
brain. But then for other women,
it keeps declining, right, the
changes keep occurring. That's
what we're trying to understand.
There seems to be a family
history component. So we work.
The first study was all done on
women who are at risk for
Alzheimer's disease, because
that's what I specialize in.
Then we extended our cohort to
women who do not have a family
history of Alzheimer's. And so
by comparison, we could say
well, those who Do have a
predisposition to Alzheimer's
disease seem to be more likely
to not stabilize, but to keep
declining. And this is not
universal is not 100%. But it
was a higher chance. Okay,
experiencing a continuous brain
decline memory decline. And
that's when we start talking
about Alzheimer's prevention,
because it's really important to
do that. But overall, to answer
your first question, it looks
like this brain rewiring can
take up to 15 years. Yeah,
sometimes it's much faster. I
don't know exactly what the
average is. But I will say
around seven or eight years,
during which we see consistent
changes for most women into
studies as well. And now we have
hundreds, I would love to have
hundreds of 1000.
Dr. Mindy Pelz: But yes, I would
love you to have not to help me
know how I let me know how I can
assist you. I've we have lots of
women that follow. Follow this
podcast that you know, if you
ever need more subjects, you let
us know it's
Lisa Mosconi: yes. In fact, I
would like to talk to you about
this. Maybe later, there are two
studies that we're actively
recruiting for. And yes, the
first thing I do so your second
question. Yeah. Before I forget
Dr. Mindy Pelz: your menopausal
rank? Yes, go for it.
Lisa Mosconi: And then No, given
it manifests, I've been closed.
So no, no, sir. Okay, that's
fine stone, if I'm preparing,
I'm actually preparing, like,
this is just a preview. I don't
know, if taking hormones would
change that. My My assumption is
that it would just make the
transition smoother, smoother,
because the transition we look
for, whether you take hormones
or not. The point is they're
hormone therapy may actually
alleviate the symptoms, you want
change the process, the process
needs to happen, I think, right?
But you have make it smoother,
and make it easier for you for
some women in this to go
through.
Dr. Mindy Pelz: Okay, so I
thought I have on that is, if
there is a pruning process that
is necessary to to step into
this new brain that you get
postmenopausal Lee, that can
serve you in so many ways. If I
start and I'm not, I'm not pro
or anti HRT, bioidenticals, I'm
just, I feel like we've gone
from a cultural hush about
menopause to cultural chaos,
where nobody knows what to do.
So I really trust your opinion
and want to, like get this clear
for women. If you start adding
in estradiol, or you start
adding in, like, you know, an
exogenous source, are you now
slowing down the pruning
process? Like, what if there's,
I'm a little bit of what if you
just need to rip the band aid
off? Let the pruning happen? And
then let the new brain grow? Or
is it just you're gonna have a
slower pruning process, but and
a little less suffering, and
you'll all will all end up in
the same place? It's just a
matter of, you know, it's not
it's not speed, it's pain of
going through the experience,
Lisa Mosconi: right. So I, I
cannot fully answer this
question, because the research
has not been done. But what we
know from basic science is that
the pruning will happen no
matter what, because it's
something that just needs to
happen. There's a good reason
for that to happen. However, it
could, the effects are
different, the perceived
effects, the symptom, the
quality of life changes, the
severity of the symptoms may be
alleviated by taking hormone
therapy. Now while we are
studying, which I think is
fascinating, and hopefully in a
couple of months, I can tell you
more about what we're doing now.
But the reason is that hormones
alone don't really matter as
much as the unit. So the
hormones only work together with
receptors, okay, and when we're
born is women are brains and
their bodies but really, our
brains are full of estrogen
receptors. We have a ton of
estrogen receptors, which means
that our brains are wired to
respond preferentially to
estrogen. Progesterone is
important to start studying is
important. Estrogen is really
important based on the quantity
of the receptors that we have,
and how much they matter for a
whole lot of things that need to
happen inside your head. So when
your estrogen concentration in
plasma is low, the brain
increases the number of
receptors to balance it out.
It's
Dr. Mindy Pelz: it's like a horn
medic stress, it makes itself it
makes itself ready for the
influx, it
Lisa Mosconi: tries to grab it,
right where your estrogen levels
are higher, like during
ovulation or close to ovulation,
the brain doesn't need as many
receptors, and so Sandbridge sap
to just recede into interests.
So once estrogen is just right
is going to be imbalanced with a
number of receptors. And that is
optimal. So what we should be
trying to do with hormone
therapy with bioidentical
estradiol, estrogen, the mother,
the bio identical, whatever
quality is that we might want to
preserve the concentrations so
that the brain doesn't have to
change its activity too much.
Dr. Mindy Pelz: Ah, so it
doesn't doesn't these receptors
don't have get out of balance?
Lisa Mosconi: Yes, that's but we
don't know. We don't know. We
don't know. You know why that
Dr. Mindy Pelz: would semester
dial should be doing it until
you research it,
Lisa Mosconi: I do. Now I can
talk to you about it. Because
it's not just that we're doing
it we're doing it we're working
on. And what we're learning, you
know, how hormone therapy is
typically prescribed after
menopause. Yeah, most providers,
if you go to a provider, you say
I still have a menstrual cycle,
even though it may be once every
few months in the head, the
symptoms, they may or may not
put you on hormones, or suggest
that you take hormones, many
doctors would prefer to wait
until you are effectively
menopausal. So to a month after
the final menstrual period, what
science says which I know
there's a huge gap between
science and clinical practice,
it takes 17 years for the
research to turn into a clinical
recommendation, I know that from
science, the right time, the
best time to start taking
hormones is before the final
menstrual period is when your
estradiol starts fluctuating
because that's going to send
your brain into a flux, just
trying to keep up. Right. So
we're studying that well. That's
from basic science, we need to
make sure that women's brains
react the same way. So we're
trying to measure that now. And
we're also going to then do
clinical trials to make sure
that we can preserve the
conversation. It's gonna take a
minute, but we're coming to the
red, hopefully,
Dr. Mindy Pelz: 17 years, so we
don't have 17 years. So you
gotta get this. Yeah, yeah,
that's what I
Lisa Mosconi: said to you,
everyone to the by the, by the
time I start going through Peri
menopause, I want answers.
Excellent. You know, I want to
know what to do. Great. So I'm
working as fast as
Dr. Mindy Pelz: I can. Okay, so
it's self serving.
Lisa Mosconi: But I also I also,
I also really want to help other
women, because there's so many
women who really have a hard
time doing none of us and
there's no research, there's
very little research, there's
very little support, there's
very little understanding, you
know, we go through puberty, and
it's it's a huge celebration.
Oh, my God, you're a Drona is
amazing. Yes, you go through you
have you get pregnant, this baby
showers. This picture has been
taken. Everybody loves you. And
it's such a one. You go through
menopause and nobody cares. No.
Dr. Mindy Pelz: You know, a
statistic that really has
grabbed me and has me searching
for answers is that the most
common time for a woman to
commit suicide, the most common
decade is between 45 and 55.
That has to be because of the
brain changes. And I've actually
seen some research that shows
there are the parts of the brain
that actually initiate suicidal
thoughts gets activated in and
now I'm looking at this a little
different, but in the menopausal
transition, that part gets
activated.
Lisa Mosconi: Oh, no. I think
it's so it's so imbalanced, you
know, some parts of the brain
become stronger, we're more
protected. And that's done at
the expense of other parts of
the brain. Right? Like what
you're saying, there's, it's
very clear to me, at least
neurologically that menopause
does not cause disease does not
make you do things, but it does
increase vulnerability to
whatever predisposition you
have. So if you have a
predisposition to depression,
it's very likely that you may
experience depressive symptoms
or receive a diagnosis of
clinical depression. As you go
through menopause. If you suffer
from anxiety, you may get panic
attacks for us in neurology,
multiple sclerosis, you know the
sign the lesions in the brain
tend to become clear. During
these transition states, the US
timers plaques. We see them very
clearly when women start missing
their cycles in perimenopause,
that's when we find the red
flags for Alzheimer disease in
women with a predisposition to
outside, right. So menopause is
a little bit of an activator, if
you will, whatever medical risks
you have, are likely to make an
appearance as you go through
menopause. So it's a little bit
of a preview for the rest of
your life, what's
Dr. Mindy Pelz: coming down?
Yeah, so So I, in my research of
trying to figure out what was
going on with my own brain,
because my brain in general, I'm
54, I've been postmenopausal for
about a year and a half now. And
the way I did I was, I should
have thrown myself a party, I
didn't think about that. I was
too busy writing books. So So
but what I the way I can
describe it is that all of a
sudden, my brain felt raw, I
could not handle the stress that
I used to be able to handle, I
couldn't put in the work day
that I used to be able to put in
I sleep, of course became
difficult anxiety and depression
showed up for no reason, there
was nothing that I can point of
my finger at. So after a, you
know, a few, like a year or so
of that, I realized that
something was shifting. And so
of course I you know, I'm the
one who loves to read the
research that that people like
you do. And I landed upon this
really interesting study that
talked about how estrogen
progesterone, and mainly those
two, that they actually also
stimulate a whole set of
neurotransmitters. So with
estrogen estradiol, specifically
stimulating dopamine and
serotonin, acetylcholine
glutamate, GABA, BDNF. And so I
started looking at this, like,
oh, it's like a shedding of a
neuro chemical armor. It's like
there is this neuro chemical
armor that has protected us from
our stressors, and has given us
this superpower to be able to
multitask and connect with other
humans. It's coming down. And as
it comes down there, we can
either curse it, or we can say
there's an opportunity here to
do exactly what you're saying.
If we How about we it's time we
handle our traumas, how about we
look at a deeper look at our
relationships through a deeper
lens? And what relationships
need to stay and maybe what
relationships need to go. Maybe
we need to look at what our
career path or what's coming
down in the next you know, as
Jane Fonda calls it our third
act like it's an opportunity
because this neuro chemical
armor comes down and then
there's a rebirth of something
new. Would you would you say
clinically like or from a
Research Lens? Do you agree with
this neuro chemical armor
theory?
Lisa Mosconi: I love it. And I
think you're coming up with like
the best analogy. Graduate is
pearls of wisdom. Yeah. So what
would estradiol does primarily,
it's, it's actually it's a
growth hormone, in many ways,
you know, it was so it was
discovered in the 1930s. By
scientists, they were studying
reproduction and fertility. And
so immediately it was done. You
know, with dog this is sex
hormone. And we've been stuck
with this definition forever.
But in reality in 1996, in the
1990s, brain scientists realize
did the same hormones that are
involved in having children or
not having children are also
just as equally important for
the functioning of our minds and
their brains. And estradiol, in
particular is the master
regulator of women's brains.
Because it's a little bit
estradiol is to the brain with
fuel is to an engine or to a car
and yep, if you look and neurons
will be estrogen receptors are
extradiegetic flows riding hits
the receptors in that activates
a whole cascade the cellular
event where energy production is
improved. Okay, as tradeo pushes
your neurons to make energy and
water right, faster and harder.
So that will mean that you have
more serotonin, you have more
dopamine, you have more
glutamine glutamate conversion,
and you have all these beautiful
things happening inside your
brain. And then it's Estrada,
you recedes, we lose these
activation effect, and the brain
is doing recalibrate and start
burning other sources of energy
instead of glucose or in
combination with glucose to
support cellular energy. So this
this is a big shock to the
system in many ways, and it's
indeed puts women at risk for
suffering more from the effects
of stress There's a lot less
Yes, the aliens to stress. We
just got published this study
that I'm very proud of, we show
that cortisol levels, right with
cortisol in serum is a marker
for chronic stress, predict the
amount of cellular Alzheimer's
plaques in the brain are
correlated with lower gray
matter density in the brain and
lower brain energy levels,
especially in women, and
especially in women who are
postmenopausal. So it's really
important to keep that in mind.
Also important because stress
release, I really stress
reduction should really become
part of the menopausal toolkit.
Yes, I would say
Dr. Mindy Pelz: yes. Okay. So
and that I only discovered by
powering through my Peri
menopausal years. And really, I
mean, I ate well, I changed my
exercise, I tried to sleep when
I could, like I repaired my
microbiome I detoxed in my 40s.
The one thing I could not get a
hold of was the I call it the
patriarchal pace, that pace of
production where you're like,
keep going, keep going, you
know, you're you're having to do
so much. And so stress stayed
high. And it hasn't been until
recently when I really just put
my foot down and said, Okay, now
I'm going to handle stress, that
I all of a sudden felt like my
brain started to come back
online. And I think that is not
emphasized enough is how
cortisol and chronic cortisol is
really before we even think of
lathering ourselves with all the
creams or putting patches on, we
have to think about what how are
we going to manage stress?
Lisa Mosconi: Yeah, because
trance, I mean, in the end, that
really syncs your hormones as
well, right? So satis hormones
and stress hormones are produced
at the same time from a common
precursor, this CO pregnenolone.
And so the body needs to make
more cortisol, it will take the
pregnenolone away from the
estrogen. Yep. And so more
cortisol, less estrogen. So I
think it's really important to
balance the two. And to your
point before, there's research,
especially from Europe and Asia,
showing that generally, once
you're past menopause by about
six years or more, the reason
any increase in life
contentment, and there's a
renewed sense of energy,
impossibilities, and it's a good
time for many women to really
enjoy their lives a lot more
than that. Yeah. And that seems
to be statistically significant.
And you know, the
anthropologist, Dr. Margaret
man, she used to call and she
used to talk about the menopause
and zest, that once you're done
with menopause, there's this
renewed interest in life, and
you feel like you have a new,
you just there's a different
Park in your eye and you you
have a different way to approach
life. And there's so much to
look forward to. And I know that
this is not universal, I know
that many women just suffer
throughout menopause and beyond.
But I think it's also important
to realize that this is not
universal. And that naturally,
more women do not tend to report
an increase in life contentment,
once they're a little bit older.
So I think there's plenty to
look forward to and to really,
yes, set your mind towards, you
know, you want to set the tone
for the rest of your life. Yeah.
And I think if there's power,
our minds are powerful, and
there's power in our choices.
And the mindset also plays an
important role that we don't
talk about that much.
Dr. Mindy Pelz: I love that.
Because if you think about let's
think about the 35 year old or
the 40 year old who's like,
starting to embark upon this
Peri menopausal journey, and has
heard about all the suffering,
yeah, all this like you. But you
know, I have so many of my
friends that are 10 years
younger than me, they're like,
Thank God, Mindy, you've already
been through it. So you can turn
around and like, help us through
it.
Lisa Mosconi: Absolutely.
Dr. Mindy Pelz: We've gone from
again, not talking about it to
now everybody's talking about
it, and they're scared about it.
And I think the next place I
would love to see the
conversation go to is this is
preparation of cultural
leadership. This is an
opportunity where you can
actually step into the most
authentic version of yourself,
and you may end up the back half
of your life, this may be the
most joyful time that you've
ever experimented or ever
experienced with. So now if I'm
42, and I'm depressed or I can't
hold on to memories, or that
suicidal part of my brain is has
been activated. If I have a
vision of where what my brain is
doing and where I'm going,
that's a thread of hope that so
many women can now hold on to as
they go through this time. It's
almost like pregnancy and birth,
like you're birthing a new
brain, and then you're gonna
have to push it out, and then
you get the reward. Yes,
Lisa Mosconi: I love this way of
thinking about it. For me, as a
scientist, I've never been
scared of menopause. I've never
been scared of pregnancy, I just
know what happens and why
happens. And I think it's so
important to, to just spread the
word and share the knowledge so
that yeah, it doesn't feel
alien, when it happens. Because
I think a lot of the reasons
that women have women may have
such a hard time during
menopause is just you don't know
what hit you. Because you're not
prepared for it. And it feels
like somebody just pulled the
rug out of you, and you feel
blindsided by your body and let
down by your doctors, and you
just don't know what to do or
how to take care of yourself. So
I think it's really important
to, first of all, understand the
science and be familiar with the
science and also the terminology
if I may, and then look at
solutions, right? What are what
are all the things that can make
this transition better, and
gentler and easier? And what
kinds of solutions would work
for you as an individual? And
there's no right or wrong
answer. So I'm also not pro HRT,
I am pro solutions, and they
most certainly encase suffering,
right? There's no need to
suffer? Yes, it's a long
transition, it can take a long
time. So I would say, let's look
at all the solutions, maybe
something will work now. And
then we'll change to something
else later. But let's just be
informed about all the things
that can actually work and then
come up with a plan that works
for you. And for me, again,
because I am a scientist, it's
important to share the right
words with women, because we're
then we're they noticed, coming
into this field a little bit
from the back door, in a way is
that menopause is really
portrayed as a medical
catastrophe. Like you look, you
open a textbook and medical
textbook and menopause in
western medicine is defined as a
state of estrogen deficiency
caused by ovarian failure. Oh,
how is that going to make you
feel? Oh, great. You know,
that's me. Is there more? And
then there are experts or other
people who are like, Well, no,
no, no, let's take a step back.
This just the scientific
definition is based on mice,
that's just considered menopause
as part of the natural aging
process. And that's also being a
little bit out of touch with
reality, there's nothing natural
about it. And that feels like
you should just kind of ride the
wave and do nothing, because
it's just natural. And so the
correct definition of menopause
is a neuro endocrine state or a
neuro endocrine transition,
where your body where your brain
and your ovaries and your
hormonal system are changing at
the same time. So this is a
biologically programmed event,
which needs to happen, however,
is not part of chronological
aging. It's endocrine aging,
which is different. It sounds
that the pros and cons were the
concert of yours. There are
sentences, they have flashes of
brain fog. But there's also pros
in the process that this is this
is needed for you to transition
to a different phase of your
life where you have just just a
completely different biology.
Right. So let's use this
terminology. Menopause is not a
disease, we do not need to treat
it as such, because it's not a
disease. You don't have to
necessarily medicate it unless
you find relief in prescription
medications, which is great if
you do wonderful, but let's
let's not start with a mindset.
This is something that's making
you sick. Yeah. All right,
because it's very disempowering,
I think. Agree. Yeah. And it's
not saying you shouldn't use
medications. It's more just
saying, let's take home. You
know, this is not making you
sick or not dying. Yeah, but
let's look at solutions. You
think it's a better what do you
think?
Dr. Mindy Pelz: Do you think I
love that? Because I think one
of the chat one of the things
that I've been really trying to
emphasize to my followers is
there's not one solution.
There's your solution. Yeah. And
so you've got to find your
rhythm with these changes that
are going on in your brain and
your body as you go through the
menopausal experience. And I
think I think one of the places
we start deceiving women, is
when we're like, everybody needs
to put a patch on, everybody
needs to do bioidenticals. And
then a woman tries it, and all
of a sudden, maybe she gains,
you know, 20 pounds, or another
woman tries it and she becomes
suicidal. Like, we have to, I
think that the way, what you
just said was so powerful. And
then I feel like we need to take
it even deeper and say, and your
goal as you go through this
experience is to find your
menopausal toolbox. And you
might sometimes need to pull out
a patch. And other times you may
need to get rid of the alcohol.
It's like there has to be a set
of tools that you're given. And
then you need to learn how to
use those tools as you go
through the experience. Yes.
Lisa Mosconi: And in the end,
you do you, you know you are the
expert when it comes to your
health and your well being. And
it's wonderful to know with
things that have helped other
women, that's obviously a
wonderful starting point. But in
the end, unfortunately for
menopause, it's a little bit
trial and error. And I think the
reason that this is the case is
that we do not have an
integrative framework for men of
yours. If you think about it,
you're going through menopause,
and you're experiencing the hot
flashes and you're experiencing
the brain fog. Maybe you can't
sleep at night. Who do you go
assume you go to an OB GYN, an
OB GYN specialist, wonderful,
but doesn't do brains. Right.
They're not trained. I mean, not
there's not a critique in any
way, shape or form. They're
wonderful specialists. But
they're not trained to manage
brain health. They're not
trained there or they don't
specialize in the brain. And
it's really, I think, a missed
opportunity. The brain
specialists are not involved in
a woman's medical checkup when
it comes to menopause care.
Because we do have something to
bring promise we bring a lot to
the table. We can really support
women through this transition.
And it's wonderful to work with
her colleagues in OBGYN so that
and also preventative
cardiology, and metabolic health
and sleep everybody. It would be
wonderful to have a more
integrative approach with all
different specialties are able
to weigh in as needed. To
address a different point, yeah,
it's a dream. We do this
actually Weill Cornell medicine,
where we collaborate with our
colleagues in OB GYN, also OB
GYN surgery. Because Leesy
surgical menopause is a little
bit harder on the board or can
be harder on the body and the
brain. We work with our
colleagues who specialize in
breast cancer and reproductive
cancer. So they were all
together. And what they do is
that they send their patients to
us for cognitive testing when
necessary brain imaging, and all
these evaluations that we do for
cognitive health and brain
health. And the other way around
our patients once we figured out
okay, these problems you're
having are much more likely to
be menopause than Alzheimer's
disease. For example. Let's go
talk to our colleagues in OB GYN
and see what they recommend for
a treatment plan. And then let's
try everything together. So I
think this this is so
Dr. Mindy Pelz: beautiful. I
wish everybody operated like
that. What do you think? Where
do you think lifestyle fits into
this? Like, how important is
your lifestyle as you're going
through? I'm going to start
calling it the pruning process
called perimenopause, it should
be called the brain, the brain
pruning process.
Lisa Mosconi: Yes. And I think
it's interesting that we define
a brain process based on the
ovaries. Right, we completely
disconnect. We don't acknowledge
the fact that the brain is
involved in menopause,
everything is always based on
the function of the ovaries,
which I think is confusing to a
lot of patients as well, because
they don't really match your
experience. But anyway, I think
lifestyle is very important.
It's really your foundation, and
is your starting point for
health. And the healthier you
are as you go through menopause,
the less likely you are to have
severe symptoms or discomfort.
And of course, it's not a 100%
correlation. But there seems to
be any impact. Things like
regular physical activity, a
healthy diet or a balanced diet,
stress reduction, sleep,
hygiene, avoiding toxins,
regular medical checkups, those
are all things that just support
health overall, and do support
Hormonal Health as well. So they
are I think they're very
important. You
Dr. Mindy Pelz: know, if I go
back to the grandmother
hypothesis, one of the things I
was thinking about when you were
talking about the purpose of the
grandmother in back in the
primal days, how if they didn't
come back with a kill Then they
had to take what they had forged
close by to the cave. And that
was probably plant based. Yeah.
So if you if you look at what
the diet for the perimenopause
menopausal woman, I would think
it was probably a mixture of
definitely some animal meat, but
you didn't have access to that
all the time. So it also is
probably very much a plant based
diet. And what I've seen as much
as there's incredible
conversation around protein
right now and the need for more
protein, which I agree with, I
also think equally for the
menopausal woman is the need for
plants, because it just off the
grandmother hypothesis.
Sometimes grandma had to go get
the plants and bring it back.
Right. And that's what we all
maybe it's not just menopause,
maybe it's all ages of female
reproductive cycling,
Lisa Mosconi: I would say then,
most of the research shows that
a plant forward diet seems to be
really beneficial for women's
health. Overall, I love that,
which is a flexible diet, and
really is focused on getting the
nutrients in Yep. Great, you can
get a lot of good nutrients from
eating plants. And then like you
said, you know, meat and fish
and higher protein sources can
be helpful as well. But it's
also good to know that you can
get a lot of nutrients from
eating plants, because really
the strongest correlations I
have seen are with fiber, and
women's health and talk. Yeah,
hormonal health and women's out
is really fiber. And you were
talking about balancing your
microbiome before. Yeah,
antioxidants seem to be super
important. Why? Because the
brain and the ovaries are
extremely metabolically active.
Oregon's and the more
metabolically active you are,
the more sensitive you are to
free radicals and oxidative
stress that are very damaging to
cells. And the only way to
reduce oxidative stress is by
importing antioxidant nutrients
from your diet. Yeah, so those
have to happen. And that's the
you know, for the microbiome,
something that was really
interesting to me is how a part
of the biker, or the microbiome
is called the Stroebel on. Yes,
Dr. Mindy Pelz: I love this
part, this is my favorite part.
Tell me what you know about it.
It's
Lisa Mosconi: so cute. I mean,
you might just the term there's
a collection of bacteria and
micro organisms in the
microbiome that are part of this
trouble on and this is this
sector of the microbial
population that is very
specifically involved in
regulating estrogen levels, by
deciding whether the estrogen
needs to be expelled from the
body eat out or not, or needs to
be reintegrated in the
circulation. And the way so it's
important to have a healthy
struggle on to make sure that
your estrogen levels are import
balanced. They're not the only
determinant. They're still being
studied, but they do seem to
play a role. Now, how do you
keep them healthy by consuming a
plant rich diet that includes a
lot of fiber oligosaccharides,
antioxidant, nutrients,
prebiotics, probiotics, so
that's another reason to consume
more plants. You know, like we
were saying before, I'm not pro
HRT, I'm not pro any specific
diet, I am pro diet that works
for you that is sustainable for
you, as long as it's healthy and
really is well rounded, includes
a diversity of plant based
foods, because those are good
for health. It's good to have
diversity when it comes to the
phytochemicals and
phytonutrients. And that is
sustainable, so that there's no
okay. I'm vegan for three weeks,
and then I'm gonna go keto
because they gain weight or the
other way around. That is much
more disruptive to keep
switching diets or keep, you
know, the yo yo dieting or Yes,
so the ranges and anything is
confusing to your body. Yes. So
I think whatever diet is
sustainable for you, that is
high, the nutrient dense diet.
Yep, I support you.
Dr. Mindy Pelz: You know what,
you you're the first person I've
talked to that has a very
similar approach to diet that I
because I feel like there's a
lot of good in all the
conversations we're having
around diet right now. The only
one I'm opposed to is the
standard Western diet, that's
chemicals and inflammatory oils,
so that you have to figure out
what diet works best for you.
And we when we become dogmatic
and we're like you eat this way,
you don't eat this way. Now I
feel like we've lost our way. We
need to look at all the
different diets maybe keto is
better for you. Maybe it's not
maybe vegans better for you.
Maybe you need to do the
carnivore diet for a few weeks.
I mean, let's look at all of
them, and like, see where they
may fit. And you figure out what
works best for you. So I just
didn't take a more holistic
approach to do than we're doing
right now. So,
Lisa Mosconi: I mean, honestly,
in the end, if you're able to
just eliminate processed foods
from your diet, at that point,
whatever diet you're own is a
matter of optimization. Yeah,
but the base is solid. So if
there's one recommendation that
we could give to people that's
religious try to stay away from
processed foods, highly
processed foods, especially fast
food, packaged foods with a ton
of preservatives, once those are
out of the diet, then, you know,
you're basically halfway through
if not more than that, yes.
Yeah. Amazing.
Dr. Mindy Pelz: So before we
close, I do have to ask you,
then what do you think of
fasting? Where do you think
fast, if I do it fast, I could
Girl.
Lisa Mosconi: Girl, better I
have. So surprisingly enough, I
have been unknowingly practicing
intermittent fasting or sort of
intermittent fasting for my
entire life. Because I was born
and raised in Florence, in
Italy. I studied in France for
high school. So in Europe, where
it's very common to have a light
dinner earlier in the evening,
especially my parents that you
met very early, like six 7pm
already. And then that's it
until eight in the morning. So
just naturally, we are raised to
go for at least 12 hours without
any food, a great daily upgrade.
And I've been doing this for my
entire life. I haven't tried to
go like 14 1516 hours, but I
have no problem doing that, like
I seen. If I need to go for a
blood test, right, and my
appointment is at 11 or 12. I
don't need to eat. I'm quite
nodding. So I think that my
body's kind of comfortable with
the idea that you don't have to
constantly eat. And it makes a
lot of sense to me because you
need to give your liver a break.
Just have right. You can't keep
munching and snacking and the
midnight free drawn into it just
a healthy practice. So that's
where I'm, I also would love to
summer research.
Dr. Mindy Pelz: But here's what
I would love you to research. I
would have put it on you. Since
I have direct access to you, and
this is the ketone. So if you
look at what the ketone does in
the studies that I've seen, one
of the things that is that as
the ketone, you switch over into
this ketogenic energy system,
what the ketone brings with it
is GABA. So actually, the more
your ketones start to kick in
not I'm not talking about
ketoacidosis. I'm talking about
a short small bursts of ketones,
you now have a little more GABA,
okay, that's really helpful to
the menopausal woman who's
losing progesterone and is
feeling anxious all the time.
And the other thing, that key I
see where I'm going with this,
the other thing that ketone
does, is it up regulates BDNF.
Well, that's really helpful for
when I'm losing Astra diawl, who
was also up regulating BDNF. Now
she's gone. Could I use my own
internal ketogenic energy system
with cycling in small bursts of
fast to get these ketones to
come in and create a
neurochemical change? That is
going away because my hormones
are starting to diminish as
well.
Lisa Mosconi: So I should point
you to the research of my
colleague, Dr. Roberta Diaz
Brinton has done a lot of
research on this. And she has
shown that indeed, the
postmenopausal brain is higher
in ketones and fatty acids,
better oxidation in response to
the changes in estradiol. So
estradiol is a glucose loving
hormone, okay, so for as long as
your estradiol levels are high
in your brain, which is not 100%
dependent on the ovaries because
the brain also makes us to dial
in house. Right? But as long as
there's enough estradiol in the
brain than the brain runs on
glucose. When Esther Dahlia
withdraws, then there's this
switch in the way that the brain
metabolizes energy or produces
energy or send you a scented
paper. It's really beautiful.
It's a beautiful,
Dr. Mindy Pelz: I'd love to see
Lisa Mosconi: where, first of
all, there's an increase in
better oxidation so the brain
starts burning fat. Then there's
an increase in ketone body
production. When they say In
Time disease, there is a
reduction in oxidative
phosphorylation. Now all this
work is done in animals going
through menopause, why these
animals experience is a first
stabilization in energy levels
that eventually leads to a
crash. So that's not good news.
No, right? Let's not do that.
However, mice are not women.
Mice are not supposed to outlive
menopause women are. So I would
be really interested in seeing
how this research translates to
women's brains. And we're trying
to do that now. Together, we
work together. So that's really
wonderful. And maybe at some
point, we'll give you a better
answer. But for now, we do know
that there is an increase in
ketone metabolism in the brain.
Yeah, it is not necessarily diet
correlated is internal. In the
brain. We don't quite know the
consequences of that in women.
Dr. Mindy Pelz: So so the way I
would translate what you just
saw me for the, for the
postmenopausal woman, the brain
could favor ketones, it could
actually be uh, you know, take
some pulses of ketones.
Lisa Mosconi: I wouldn't say
favorite, the brain has to
switch to ketones.
Dr. Mindy Pelz: It okay, it's
necessary. Okay. So yeah, and I
don't because then people will
get people
Lisa Mosconi: are gonna think,
Oh, we really want as ketone
body. We're on a keto diet are
sensitive. Yes. Well, more
sensitive has to switch. It has
to switch. So before it was
running on glucose, and now the
glucose is kind of reduced. We
need to switch to an alternative
energy source. Yeah, yeah, we
become a hybrid. The brain
becomes more of a hybrid.
Dr. Mindy Pelz: Yeah. That I
mean, like a hybrid car. I see
that all the time. Yeah. So
which is kind of how I found
fasting was in those Peri
menopausal years when the brain
fog kicked in, I realized at
certain points of my cycle, is
that if I actually fasted, all
of a sudden I had mental
clarity, it came back online.
That's so it was all in my Oh,
and then I noticed it with my
patients and my online community
the same way. So now again,
Lisa Mosconi: to do a clinical
trial of that, because they
efforts, yeah, many women come
to me and say, you know, now
that I'm doing fasting, my brain
is kind of coming back to life.
You know, that's right. And I
was like, Yeah, tell me, I would
love to study that more in
depth. We can say find, please.
We have a lot of basic science.
A lot. We have some basic
science done. But the studies in
humans, especially women, who
are not the bees, were not
athletes. We need more, we just
need more, right? Yes, we need
what's happening because it
could be a really wonderful
tool. Yes, and we've studied.
But if I do, I don't call you.
Dr. Mindy Pelz: I will I will
send all the men of
postmenopausal Peri menopausal
women, I'm sure those of them
listening right now will say a
hell yes to that. Because what I
love is the power of the ketone
is its internal resource you can
tap into. And we really need to
be thinking about free ways to
help women, it can't always be
an expense. And what I love
about fasting is if you learn
how to cycle fasting, it is
completely free. You just need
women need to know how to do it
for their hormones. And, and in
all the research I've seen, we
don't have enough research on
women, and we definitely don't
have enough on post and
postmenopausal women. So so I'm
going to I'm going to tasked you
with doing that. So anyways,
Lisa, this is thank you for
giving me so much of your time i
i have to tell you, this is one
of my favorite conversations
that I've had in such a long
time because what I've asked you
are questions I've been asking
myself and I have been trying to
find answers to I was one of the
the fans that ordered this book,
the minute you put something out
about it. I was like, I want
this book, I got to get this
bug. And the minute it came to
me I scoured through looking for
all my answers. And so what a
delight for me to be able to
have this conversation with you
is just real treasure on a
personal level. So thank you so
Lisa Mosconi: much. And you
know, you really make it fun.
Thank you promise me as well.
And thank you, I really, really
appreciate it and just the
opportunity to talk to you and
your followers into women and
just share the knowledge and
bring the science out of the lab
is extremely. It's just
wonderful. And I thank you for
that.
Dr. Mindy Pelz: Yeah, it's like
we're all necessary in the
conversation, right? Like, we
need all of us to be opening
this up and having this
beautiful conversation so that
We women feel heard? I think
that's the most important even
if we don't have answers. Yeah,
Lisa Mosconi: so I'm not for
sure. And also that the recent,
it's not black and white. I
don't spend a lot of time on
social media. But when I do
sometimes it's a little bit
daunting because I go, Oh, my
goodness, did you just say the
grid? And I find it very
intimidating. Like, if I
approached this as, not as a
scientist, or researcher, I
would be very confused, and
perhaps a little scared, because
it thinks that you're here. So I
think it's important to have a
more balanced conversation
where, yes, obviously, menopause
is no picnic. Right? And we need
to speak to that. And the
knowledge, women have been
reporting for 1000s of years
that we need support, there has
to be more pharmaceutical
development, there should be
more research looking at
lifestyle and behavioral
interventions as well. But it's
so so good, then. I think it's
good to know that it's not doom
and gloom. And then there's a
positive, much more positive way
to think about this life change,
intervene accordingly, right,
nobody should suffer. But at the
same time, keep an open mind and
the positive attitude, because
in the end, most women spend a
third of their life in a
postmenopausal stage, we can't
approach it is something we
don't want. That's
Dr. Mindy Pelz: right. So well
said. Okay, I have to finish up
on this question. I could talk
to you all day. I always asked
every guest because I think that
we often don't have language to
what health is. So we all have
our own personal language. So
what does health mean to you?
And you've already spoken of
some of your health goals. Do
you have any health goals for
yourself that you're currently
working on?
Lisa Mosconi: So many? My
husband thinks I'm nuts. I just
as I go through the research,
I'm like, Okay, I'm going to
enter perimenopause soon enough,
I suppose. I want to be
prepared. I want to do
everything I possibly can to
make it easier on myself and on
him. You know, we have, of
course, yes. Yeah. We have a
realization like, yeah, yeah.
It's also my daughter is
probably going to go through
puberty when I go through
period. So it's important that
we support him in that. So yes,
I mean, for me, health is just
being healthy, being comfortable
in my own skin, I feel like I
have the energy to do things.
And I look forward to just
waking up in the morning and
living my life. You don't have
to worry about oh my god, I
can't do this because I'm not
feeling good. Or I can't go
there because I have a headache
or I don't want to feel limited.
So how being healthy is the way
to be free. And freedom is
really important to me physical
and intellectual. So well said I
love it's an investment. I
think, you know, health is
wealth, but also brain health
really is the ultimate treasure,
at least for me. So I really
optimized for brain health. And
I come from my last two years
have been really demanding, like
I've been working 5060 hours a
week. I don't really I remember
my last lunch break was in April
2021.
Dr. Mindy Pelz: Oh, my God.
Lisa Mosconi: Yeah, I mean, I
eat obviously, but in a hurry.
Like I mean, an actual lunch
break when I'm not working. At
the same time. We're not talking
about work, it isn't. So my goal
is to, to really engage in more
self care and find some time for
me more and for my family
members to have a more balanced.
And I think it's possible now
that the book is out. And I'm
kind of saying no to a lot of
things. Yeah, you have to do at
some point. I'm fortunate that
I'm in this position where I can
actually choose what I'm going
to work on and what I'm doing
and not doing. So I know. I'm
very blessed. I know that not
everybody has this luxury. I
also think I earned it. Honors.
Dr. Mindy Pelz: Yes. Yes, you
did. Yes, you did. So
Lisa Mosconi: thank you so much.
I think we've done three if
you've joined me how many?
Three? This is my third. Yeah,
Third time's the charm. Yeah, it
I think getting back into having
a regular exercise routine. I
love working out. I love it. And
sometimes I just can't find that
kind of window time that I can
actually relax and just work.
I'm usually just like, Okay, I
have 20 minutes. What can I do
in 20 minutes. And now I'm like
right now, I'm going to have
time. I don't work. I don't want
to work on weekends. If I can
avoid it. I want to spend time
with my family and I've been
meditating for a really long
time. So that really helps me.
As we talked about, I don't eat
at night. It's a kind fasting,
ate super healthily, in general.
That's a good foundation and
sleep. Yeah.
Dr. Mindy Pelz: Yeah, get it
while you can. Yes. Yeah. Yeah.
Well, Lisa, this was amazing.
How do people find where do we
send people for your book? Yes.
If the typical spots.
Lisa Mosconi: Yes, typical
sports. I have a website. I'm
going to have a ball. It's at
Lisa Mosconi that calm and then
on Instagram is probably the
best way. I'm more active on
Instagram. You're on Yeah, I'm
scary. It's scary for me social
media is the Wild West
Dr. Mindy Pelz: it's a lot It is
scary. You have to you are
putting yourself out for
constant interpretation. So
yeah,
Lisa Mosconi: even never
occurred to me to be rude to
another person. Maybe online or
otherwise. It's just occurred to
me. No, I agree. And very
strange. Yeah.
Dr. Mindy Pelz: Well, this is
amazing. I we're gonna keep this
conversation going someday, I
hope to meet you and just thank
you for this. This was was it
this was like so thirst
quenching to my mind. And I just
appreciate all the work you're
doing. And we just have to keep
helping women see the
information that all of us are
bringing, and so that there's
hope, there really needs to be
hope. So. Thank you for all you
do. Thank you. Thank you so much
for joining me in today's
episode. I love bringing
thoughtful discussions about all
things health to you. If you
enjoyed it, we'd love to know
about it. So please leave us a
review, share it with your
friends and let me know what
your biggest takeaway is.