# Understanding the Changes in Your Female Brain After 40 with Dr. Lisa Mosconi

An episode of [Live Like a Girl with Dr. Mindy Pelz](https://invisiblenetwork.ai/podcast/1503897906), 6 May 2024, 1 h 27 min.

Audio: https://media.transistor.fm/5d7d664b/bd6b8280.mp3

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.

## Chapters

- 0:01 Introduction to Lisa Moscone and Brain Conversations
- 3:29 Empowerment and Health on the Resetter Podcast
- 3:53 The Impact of Lisa's Work on Understanding the Brain
- 6:34 Neurological Changes During Puberty, Pregnancy, and Menopause
- 9:25 Compassion and Appreciation for Brain Changes
- 10:29 Primal Reasons for Brain Changes in Puberty, Pregnancy, and Menopause
- 20:50 The Purpose of Brain Changes in Menopause
- 21:59 The Grandmother Hypothesis Explained
- 30:57 Effects of Hormone Therapy on the Brain Pruning Process
- 36:01 Importance of Brain Imaging Studies in Menopause Research
- 41:04 Balancing Estrogen Receptors in the Brain
- 42:56 Accelerating Research to Support Menopausal Women
- 43:31 Alarming Statistics on Suicide and Menopause
- 44:14 Increased Vulnerability and Mental Health in Menopause
- 1:02:23 Brain Health and Collaboration: An Integrative Approach
- 1:10:06 Personalized Nutrition and Health: Finding Your Menopausal Toolbox
- 1:15:44 Neurochemical Changes in Menopause: The Role of Ketones
- 1:22:44 Health as Freedom: Prioritizing Brain Health
- 1:25:33 Connecting with the Author: Navigating Social Media Platforms

## Transcript

[0:02] Dr. Mindy Pelz: On this episode of The resetter podcast, I got a
[0:07] crazy treat for you. I have brought you Lisa Mosconi. And
[0:14] this conversation for all of my perimenopause, menopause and
[0:20] postmenopausal friends out there. This is the brain
[0:25] conversation I've been dying to bring you. So let me tell you
[0:30] who Lisa is and what you're about to hear. So, hopefully
[0:35] you've heard of Lisa, but if you haven't, she has written the xx
[0:38] brain. And Her most recent book is called the menopause brain.
[0:43] And she is a neuroscientist and she is in deep with research
[0:48] specifically around all aspects of the female brain. The most
[0:53] current research she has been doing is on the menopausal
[0:55] brain. So I have been dying to bring her to you all to really
[1:00] dive into some key helpful pieces of information we can all
[1:05] use to navigate this crazy brain experience that many of us have
[1:11] as we go through the perimenopause and menopausal
[1:14] journey. So with that said, here's what you're going to
[1:18] hear. So for starters, we talked about three major times in a
[1:23] woman's life where there is a neuronal pruning that happens.
[1:27] What that means is that the brain actually starts to get rid
[1:31] of what no longer serves it, and a new brain is formed. So we
[1:36] many of these three times of life will be familiar to you.
[1:40] It's puberty, pregnancy, and perimenopause. But what is
[1:44] fascinating about what Lisa and I discuss in this is that when
[1:49] you look at puberty, there's a very specific reason the brain
[1:53] needs to prune itself and grow bigger. We talk about that. When
[1:57] we look at pregnancy, same thing, very specific reason we
[2:01] need to do away with some of the neurons that are weighing us
[2:04] down so we can tap into being able to take care of children,
[2:09] we talk about that. But here's where it gets really fun, is
[2:14] what is the primal reason that the menopausal brain needs to
[2:18] prune the old and grow a new brain. And that is the part of
[2:23] convert this conversation where this gets really interesting. So
[2:28] if you want to make sense of what's happening to your brain
[2:31] as you go through menopause, this is the episode for you. In
[2:34] fact, I love it so much. I hope you share it with all your
[2:37] menopausal friends. If you're also asking like, what do I do
[2:41] about HRT, Should I do it? Should I not do it? We discussed
[2:45] this in a very balanced conversation. I loved that part
[2:49] of the conversation. And then we dove into diet, what diet is
[2:53] best for the menopausal brain. And of course, we landed on
[2:56] fasting. What does Lisa think of fasting and ketones and its
[2:59] experience to the menopausal brain? Phenomenal conversation.
[3:04] This, I bring you this was so much joy. I hope it gives you so
[3:08] many answers. And please share this out because this is what I
[3:13] have been trying to synthesize and bring to women for the last
[3:18] several years. And we just nailed at least an eye in this
[3:21] conversation. I'm so excited for you to hear. So Lisa Mosconi,
[3:26] the menopause brain. Enjoy. Welcome to the resetter podcast.
[3:32] This podcast is all about empowering you to believe in
[3:37] yourself. Again, if you have a passion for learning, if you're
[3:42] looking to be in control of your health and take your power back,
[3:46] this is the podcast for you. Gosh, I have so many things that
[3:55] I personally want to say to you. For starters, the xx brain. I've
[3:59] read that several times. It was one of those books that as I was
[4:04] going through my Peri menopausal journey, I was just trying to
[4:08] understand why my brain was thinking different. And even
[4:12] though so much of that book was geared towards women of all
[4:16] ages, it was like the only resource we had at the time. And
[4:20] it actually took the xx brain actually took I went from my, my
[4:25] what you taught me in that book to PubMed, and I started just
[4:28] looking into PubMed and I was like, Okay, well what about what
[4:32] happens when estrogen goes away to the brain and what happens
[4:35] when testosterone and progesterone and I started doing
[4:38] all my own research, which I want to talk through with you
[4:41] today. But I also then when I saw the menopause brain came
[4:45] out, I was like, Thank you, Lisa. Thank you because we
[4:49] needed a more a deeper conversation specifically around
[4:52] the menopause brain. So that's my intro to say that I am I'm a
[4:57] total fan and I'm so so excited you wrote this book. So let me
[5:02] just say welcome. And thank you so much for putting the time and
[5:06] effort into this book. We really needed this.
[5:09] Lisa Mosconi: Thank you. Thank you so much. I so appreciate it.
[5:11] When I wrote my very first book, brain food, everybody wanted to
[5:17] talk to me about Alzheimer's prevention. So then I wrote the
[5:20] xx brain, which is really about Alzheimer's prevention in women,
[5:24] and what everyone wants to talk to me about with menopause. Yep.
[5:29] And so now, I know that everybody wants to talk to me
[5:34] about the mommy brain, pregnancy and mothers. Oh, yeah, daddy
[5:39] prespray. Now, this is so funny. And if you want we can talk
[5:42] about this more later. But I'm, who was speaking with Gabby
[5:46] Reese, it wasn't her podcast. And I just said something to
[5:50] her. Just anecdotally, I thought that we're just doing like an
[5:53] either warm up conversation. In this snippet is like a 20
[5:58] seconds thing about how women's brains change in pregnancy and
[6:03] with motherhood, just went viral with almost 2 million views.
[6:06] Wow. And it was like, Oh, my God, this is something I just
[6:09] that kinda like conversationally, and I wish I
[6:11] did that. I wish I just had more time to elaborate more. So maybe
[6:15] we can spend a minute on that at some point.
[6:19] Dr. Mindy Pelz: Did mommy brain in the menopausal brain are both
[6:22] massive shifts in hormones? So they, they, they I would think
[6:26] they act very similar. Yeah. You look at it. Yeah.
[6:31] Lisa Mosconi: So that's not the fun fact that shared with her.
[6:35] But yes, we are now looking at similarities between menopause
[6:41] pregnancy and puberty. Yes, not. Because these are all pivotal
[6:47] times in a woman's life that I referred to in the books if the
[6:51] three P's right puberty, pregnancy, and Peri menopause,
[6:56] during which brain aging or brain development is
[7:00] substantially impacted, and progresses in ways that we don't
[7:05] usually associate with aging, where, when you think about
[7:10] brain aging, I think we're all familiar with those kinds of
[7:13] graphs, where you see that when you're 3035, everything is great
[7:18] and flat, basically, the curve is the neuron density curve is
[7:21] flat, and after 3540 is a slow, gradual decline in the number of
[7:26] brain cells in the we have and then for some people is faster
[7:31] for some people is gentler, forget it, if you're a woman,
[7:36] that kind of model is almost 100%, based on studies done on
[7:41] men, were there brain aging is actually quite gentle and
[7:46] linear. But if you look at the way that the female brain, a
[7:50] woman's brain changes throughout the lifespan is way more
[7:54] complicated than that, because as soon as we hit puberty, or
[7:59] brain gets in sync with the ovaries, right, this connection,
[8:04] the neuro endocrine system gets activated. And from that moment,
[8:08] on, every time the ovaries cycle, the brain micro cycles,
[8:15] right, there's nothing flat, they're just like little waves
[8:18] throughout your entire reproductive life. And then once
[8:21] you get pregnant, there is an over activation of this system
[8:25] that then is followed by a little bit like a crash and burn
[8:29] postpartum. When the brain goes through a massive remodeling,
[8:35] when some parts of the brain lose volume, and shrink in some
[8:39] other parts of the brain actually gain volume in gaining
[8:43] increasing connectivity. So it's not linear. It's more like a
[8:46] tornado. Right? Every time a woman gets pregnant, and then
[8:50] there's menopause. That's another major turning point with
[8:54] another little tornado, and then cellular aging.
[8:59] Dr. Mindy Pelz: Big. Can we call it a little bit bigger than a
[9:02] little? Like a hurricane? And major? Yeah, there's some. Yeah.
[9:12] Lisa Mosconi: It's more like a breeze. And for some women can
[9:15] be really massive. But then when you look at the whole
[9:19] trajectory, there's nothing linear about it. It's very
[9:23] complex. And we never talk about this complexity. And you know,
[9:27] we never give women credit for navigating this inherent
[9:32] complexity, making through it and taking care of everybody
[9:36] else at the same time.
[9:39] Dr. Mindy Pelz: So you know, what's interesting, thank you
[9:41] for saying that. And then one of the three lines that I read in
[9:44] your book that I just love is this compassion for ourselves.
[9:48] And one of the appreciation Yeah, one of the things I've
[9:52] noticed about women is that when our health goes off, we don't
[9:56] tend to blame the people around us. We turn on ourselves. Yeah,
[10:00] and we blame ourselves. And this is why I think discussions like
[10:04] this books like yours are so important because all of a
[10:07] sudden a woman sees herself. And she's like, Oh, I'm not alone,
[10:11] oh, this way that my, my brain has been thinking is actually a
[10:15] hormonal shift. It's not because I hate my job, or I hate my
[10:19] kids, or I don't want to be with my partner anymore. I mean,
[10:23] those can be like situations. But it's, I think giving
[10:27] language to these brain changes is really interesting. The thing
[10:31] that I find fascinating about these three P's is that each one
[10:36] of them, there is a primal reason the brain is doing what
[10:40] it's doing. And when you look at puberty, and you look at
[10:44] pregnant pregnancy, or postpartum, you come out of
[10:48] those initial experiences. And that's like, the brain has to
[10:51] function in a heightened way to be able to adapt to the new job.
[10:57] Postpartum is a great example, when you said, Oh, it's switch,
[11:00] all of a sudden, there's new neuronal growth and other parts
[11:03] of the brain. It's like, well, yeah, that makes sense. Because
[11:07] you need to be able to use your brain in new ways to be a
[11:10] mother. But in menopause, also, I don't. Okay, so that's, this
[11:16] is the root of one of the major questions I have for you, is if
[11:21] we have this hormonal shift, which is also followed by a
[11:24] potentially by a neurotransmitter shift that I
[11:27] want to talk to you about, what what is the upside? Where's the
[11:31] brain going? As these things are shifting? And what are the new
[11:35] things that are coming online for the menopausal woman? And I
[11:38] think if, if we understood that we could weather the storm a
[11:42] little bit better? Yes.
[11:43] Lisa Mosconi: And I loved it, you're interested in that part.
[11:46] So when I was writing the book, I had this super long part about
[11:50] puberty, pregnancy and how they really help menopause makes
[11:55] sense. And then I thought, Oh, everybody always says that. I
[12:00] overdo it with the science. And so I showed them in short, and
[12:04] they but Oh, my God, I love that part so much. Can I can I
[12:09] elaborate up?
[12:10] Dr. Mindy Pelz: Yeah, give it to us. Now, I love this. Yeah, this
[12:13] is like
[12:14] Lisa Mosconi: 100% neuroscientists take on
[12:18] beautiful women's brains as we go through reproductive changes.
[12:22] So what happens at puberty for both boys and girls, is that the
[12:28] connection with the reproductive system turns on, and it is
[12:31] important to realize that the major drivers of evolution are
[12:36] having sex and having children and being able to feed yourself,
[12:40] right. So a huge part of your brain is actually wired to
[12:46] respond to reproductive health. This is just evolutionarily
[12:50] sound information, because we know that there's a huge part of
[12:53] the brain that is network with the reproductive system. So a
[12:57] puberty, humans are supposed to start having children, or at
[13:03] least are able to start having children, right. So you can't
[13:07] still be a kid, your brain needs to switch and prepare for the
[13:11] new job with the new job is allowing you relatively young
[13:17] human, to not only become apparent, possibly, but also to
[13:22] become a member of society. Because humans are not
[13:26] particularly strong animals in some ways, right? You have to
[13:30] fight and hunt is a team. And that's really how the human race
[13:35] survived is by bonding with each other and sticking out together.
[13:39] So the brain rewires itself in two ways. Number one, there's
[13:46] pruning, there is a huge amount of pruning the play with almost
[13:50] 50%, almost half of all your neurons are gone. The brain just
[13:55] says this is my biological clue to get leaner and meaner, if you
[14:01] will. Why is that important? Because neurons are extremely
[14:06] expensive to carry. So as the brain Yes, so the brain is the
[14:11] most metabolically expensive organ of the entire body takes
[14:16] up a huge amount of energy and resources, not just to make it
[14:20] work, but also just to have all those brain cells. So if you
[14:23] don't need them, it's best to get rid of them. Now, what kind
[14:28] of brain cells you don't need anymore? Plenty because at this
[14:31] point, you can tie up your shoes. You can make your own
[14:34] food, you can find your way home, you can ride a bike,
[14:38] right? All these little neurons that were responsible for
[14:41] encoding every little step of the way. Those are not needed.
[14:45] Because at that point, you can do all these things in
[14:47] autopilot. Yeah, so the brain can just get rid of all this
[14:51] stuff, you know, as a spring cleaning, I don't need it. Let's
[14:54] give me the then. And now let's put all our energy and resources
[14:59] to Words, reassembling to notice that we're keeping to make them
[15:04] stronger and better connected. So if you're a brain, you want
[15:08] to actually be a little bit smaller, but more dense, you
[15:12] want to have a higher density on neurons inside the brain. What
[15:15] part of the brain is rewiring and getting stronger? This
[15:20] theory of mind network, these various special network that is
[15:26] involved in developing social cognition mentalizing,
[15:31] developing empathy and the ability to put yourself into
[15:35] another person's shoes. Right. So for girls, this remodeling
[15:40] happens a little bit earlier on in life around age 1112. As we
[15:45] hit puberty, for boys, it takes a little longer around age 1415,
[15:50] which many people say this is the neurophysiological correlate
[15:55] of the fact that girls tend to mature neurologically a little
[16:00] bit earlier than boys, then the brain keeps growing. But all
[16:05] these changes that take place are really the mechanism by
[16:10] which your brain allows you to become an adult. Now, this
[16:16] process is wonderful and is really the key to keeping
[16:19] society alive. However, it's not painless, right? Every time the
[16:25] brain rewires itself, there may be consequences. This became
[16:31] motions, rather reckless behavior. All this drama and
[16:37] finances go through, I would say all day, the weakness and the
[16:42] brain fog, and the sweatiness there are a lot of neurological
[16:46] sciences, psychiatry, psychiatric symptoms that are
[16:50] correlated with becoming an adult with puberty in other
[16:54] adolescence. Fast forward to pregnancy, which obviously only
[16:59] women go through incentive really similar happens in other
[17:03] time, so the brain sheds neurons, which is getting rid of
[17:08] a lot of gray matter, not a lot. I mean, relatively speaking,
[17:12] there's some gray matter loss, which, in my opinion, is another
[17:17] clue to let go of a bunch of stuff you no longer need.
[17:20] Because at that point, you'd like to leave a bit older, you
[17:23] need to make room for becoming a mother. So the brain rewires
[17:29] itself another time in once again, this theory of mind
[17:33] network gets an upgrade in the same place is the same nice,
[17:39] yes. So the reproductive system is always connected to the same
[17:43] parts of the brain. Right? Okay, the theory of mind network is a
[17:47] really important one. And then there's the cognitive estrogen
[17:51] net. So both these parts of the brain, which is huge, and the
[17:56] brain really changed together, every time we go through these
[18:00] transformations. And so, pregnant women, especially after
[18:05] the baby's born after postpartum, there's a reduction
[18:08] in gray matter, but the strengthening of some other
[18:11] parts of the brain that the theory of mind, because now you
[18:14] really have to rely on your intuition, you literally have to
[18:19] be able to read minds, because that baby will not speak to you
[18:23] coherently. But a really long time. Uh, you need to make sure
[18:27] the baby survives, you need to protect the baby from danger,
[18:32] you have to feed the baby, you need to function on those leap.
[18:36] So there's a lot that your brain needs to be able for you to do
[18:40] for you to succeed. Right. So once again, there's the upgrade,
[18:45] there is the supermom brain, yet. There's also baby blues.
[18:51] There's postpartum depression, there's sleeps with night,
[18:55] there's brain fog. There is confusion, there's reduced
[18:59] focus, right? All the things that we associate with the mommy
[19:03] brain, usually in a negative way without thinking what but look
[19:07] at all the things that you can do now. Yep. Right. Right. And
[19:12] fast forward to menopause, again, is the same brain
[19:16] network. But what happens now? You're done having children. You
[19:21] don't need all those neurons. They weren't responsible for
[19:25] having a menstrual cycle. They were responsible for hosting a
[19:28] pregnancy, they were surprised that they were making you the
[19:33] super intuitive mom. So it's possible that the brain just
[19:36] shuts those neurons again, just another pruning going on. And
[19:41] then the brain revived rewires itself another time and we this
[19:45] is not published yet. But we find evidence that connectivity
[19:48] in the brain is increased after the menopause transition in some
[19:55] parts of the brain this time more frontal. So it's more
[19:59] plenty Aha, yeah, it's more about planning is more about
[20:03] being rational. Yes, it's more about being in control. So less
[20:06] impulsive, less reactive, more stable, more centered, more
[20:11] grounded. And if you think more empathic, there's another boost
[20:15] in empathy. And there's a there's a boost from, we would
[20:20] say, emotional transcendence, you would probably say given
[20:24] fewer. F. But yeah, you
[20:28] Dr. Mindy Pelz: can say you can swear on this podcast, you get
[20:32] you do, I can tell you as opposed to menopausal woman, you
[20:35] do get give a lot less fucks.
[20:37] Lisa Mosconi: This comes up so many times. Yeah, with everyone
[20:40] we talked to everybody is that, you know, I just don't sweat the
[20:43] small stuff anymore in the org. But it comes up all the time.
[20:48] And I think it's such a blessing in so many ways.
[20:51] Dr. Mindy Pelz: I think that was so beautifully described,
[20:53] because I now where my brain goes, is so then what is this
[21:00] the purpose like with with puberty, the purpose is to
[21:04] become the way I interpret what you said, the purpose is to
[21:07] become a higher member of the community, like a more higher
[21:12] functioning member of the community, with with postpartum,
[21:16] the purpose becomes to have this really good intuitive sense for
[21:20] your baby. Okay, so if all of a sudden there's another pruning
[21:24] that's happening in menopause, and now all this upside comes
[21:28] in, what is our purpose? And specifically, what is our
[21:33] purpose in relation to the cultural society?
[21:37] Lisa Mosconi: Yes, so there are theories where all these changes
[21:41] are really in place to support women to transition from being
[21:48] reproductive, to be non reproductive, but remaining
[21:53] highly productive. In the best, the best theory is the
[21:57] grandmother hypothesis.
[22:00] Dr. Mindy Pelz: Ah, yes, right. Exactly. That to everybody? Yes.
[22:03] So
[22:03] Lisa Mosconi: I find it to be a beautiful, beautiful theory, at
[22:06] least not everybody buys into it. But I think that the
[22:10] premises, the neurophysiological premises are sound in the
[22:13] genetics or sound up to explain it. So the grandmother
[22:21] hypothesis was developed by Dr. Hawks, Kristin hawks, where she
[22:26] was studying the hartsdown, a tribal community. And she was
[22:32] really interested in dispelling the myth of men, the hunter,
[22:38] because she was saying, Well, look, when men go out hunting,
[22:44] more often than not, they actually come back with nothing,
[22:48] they come back empty handed, right. So it Dougie isn't
[22:53] bringing back the bacon, who is who is taking care of the babies
[22:57] and the elderly and everybody else. And it turns out, it's the
[23:00] women. Yes, they're foraging. But that's really what provides
[23:06] the vast majority of sustenance for the entire community, most
[23:10] of the time, not always, but most of the time. But then she
[23:14] went a little bit further, she kept studying these, these
[23:16] women. And she realized that once the younger women started
[23:22] having children, the older women who were past menopause, they
[23:28] just stepped in and started taking care of everyone
[23:32] everything. So they will do all the foraging, they will take
[23:36] care of all the grandchildren, they will effectively raise the
[23:41] leader ones, so did their own daughters with daughters in law
[23:45] could keep having children themselves. So effectively, they
[23:49] stepped into a leadership position that was only made
[23:53] possible by their boss being postmenopausal. Because at that
[23:58] point, there was no competition for reproductive fertility,
[24:02] daughters. And also they will not risk dying by keep getting
[24:08] pregnant at older ages. So in a way, that was a win win
[24:12] situation, that is actually really interesting to me as a
[24:15] scientist, because it goes clearly against Darwin's theory
[24:20] of evolution, which again, was developed by men based on men,
[24:25] right, where you're saying the only purpose of being alive on
[24:29] this planet is to pass your genes on to the next generation.
[24:35] This is only true if you're a man, right? Because men are
[24:39] fertile into their 70s and 80s sometimes, but for women that
[24:44] will be extremely disadvantaged, there will be an extreme
[24:47] disadvantage. And so I started to think well, what if nature is
[24:51] actually not as misogynistic as those were writing about it?
[24:58] Because look at this present, right? If you look at this
[25:00] process, yeah, from, from a female perspective, it makes so
[25:05] much more sense to start so much being reproductively viable at
[25:10] some point and remain alive, so that you can just enjoy the rest
[25:14] of your life but also being effectively taking care of
[25:17] everyone.
[25:19] Dr. Mindy Pelz: Right? Oh my god, okay, you just answered a
[25:23] three year quest that I've been on to figure out why the female
[25:29] brain changes the way it changes during menopause. And one of the
[25:33] things that fueled me even more is I brought Dr. Amen onto my
[25:37] podcast. And and I trust his opinion. And I asked him, I was
[25:41] like, tell me why we have this massive change in hormones. And
[25:46] I want to get to neurotransmitters here in a
[25:48] second. Why does the brain go through this in the peri
[25:51] menopausal years? And what is the body up to? And his response
[25:54] was, oh, you weren't meant to live as long as we're living
[25:58] right now. Right. So that made me so mad, because I was like,
[26:04] so wait, were we supposed to just be tossed aside once we
[26:08] stopped reproducing? But I couldn't answer the question of
[26:12] what happens to the brain for the good. Like, where does the
[26:16] brain go when you get on the other side of the peri
[26:19] menopausal process? And you just said it so brilliantly. And that
[26:24] needs to be every woman listening needs to understand
[26:29] that's where your brain is going? How many how much
[26:31] suffering would be helped if we knew that was the brain, the
[26:34] brain is no is training for a leadership position in the
[26:39] culture?
[26:40] Lisa Mosconi: I love that. That's right. It's so beautiful.
[26:45] It's training for a leadership position. Oh, my God, I love
[26:48] that. Yes, it's beautiful. And look, what he mentioned is the
[26:52] opposite theory is called the mismatch hypothesis. Okay, a
[26:57] menopause that is 100%, derived from Darwin's theory of
[27:00] evolution, and was really what everybody thought menopause was,
[27:06] until the grandmother hypothesis and some derivatives started
[27:10] being formulated and confirmed and replicated and whatnot. The
[27:16] theory was, and this I think, is very important to recognize
[27:21] then, if you are born with ovaries, the idea of going
[27:26] through menopause is a no brainer, right? We just now that
[27:31] at some point, the ovaries will start with stop ovulating and
[27:35] then we're going to go through menopause. But in reality
[27:38] menopause isn't is a major biological Riedel be because we
[27:44] do. Yeah, riddle is, it's a puzzle. It's a big question
[27:48] mark.
[27:48] Dr. Mindy Pelz: It feels like a riddle when you're going through
[27:50] it. Yeah. Oh, yeah. So
[27:51] Lisa Mosconi: for sure. But this if you just look at biology,
[27:54] most female animals do, in fact, die. Their lifespan coincides
[28:01] with a reproductive span, but not for women. And women are one
[28:06] of very few species on the planet animal species who are
[28:10] who have evolved the ability to live past menopause. So the only
[28:16] other species are some whales. That's killer whale. Okay,
[28:24] norwall. Another type of whales, one type of the Asian elephant,
[28:29] one type, when, perhaps one type of giraffe. And then a little
[28:34] bug is called the Japanese a fit? For whatever reason,
[28:38] obviously doesn't mean straight, but is able to outlive
[28:43] fertility.
[28:45] Dr. Mindy Pelz: Yeah, what? What are the reason why though? Why
[28:47] are there only a handful of species that that have this
[28:50] function. And
[28:51] Lisa Mosconi: well see, it just sticks to evolution into an
[28:54] adaptive quality, because it's really hard to leave without the
[28:59] super powers of your hormones. So there has to be a big
[29:04] adjustment that takes place where your entire body and brain
[29:10] is able to find a new way to function that does not include
[29:15] estrogen, progesterone, and to some extent, testosterone, but
[29:19] switches to alternative routes. And there is a big
[29:23] accomplishment in the thing when people say you were supposed to
[29:27] die after menopause. And it's only that modern medicine and
[29:32] technology is keeping us alive for longer than nature intended.
[29:37] Then thinking no real. I mean, perhaps but the reality is that
[29:43] this kind of evolutionary changes take a really long time.
[29:48] Yeah, to a core and it's every woman on the planet. So this
[29:53] cannot have happened in the past 50 years. There must be
[29:57] something genetically that is more Ancient, yes, that is being
[30:03] perhaps pushed or boosted by improvement in health quality.
[30:07] Of course, that will play a role as well. But it can't be the
[30:10] only reason there has to be more. Because otherwise, it just
[30:15] weird. I mean, I think genetically, it would be a
[30:18] little bit too quick of a change. Yeah.
[30:20] Dr. Mindy Pelz: Okay, so that leaves me to two questions. One
[30:23] is, I know, this is like, you have no conversation I've been
[30:28] dying to have and you're just you're, you're sparking so many
[30:32] answers for my curious brain. Good. So how long as this
[30:36] pruning process supposed to take when you're in menopause? And is
[30:41] there a way to speed it up? And what happens if all of a sudden
[30:48] I start putting patches and creams and turkeys and pellets
[30:53] and I start manipulating the system with an exogenous source
[30:57] of hormones? Does that change what is supposed to naturally
[31:00] happen, which is what I now I'm going to think about is a
[31:03] pruning so that you can be take on this cultural leader position
[31:08] that we are meant to be in. Right.
[31:10] Lisa Mosconi: It's a wonderful exercise. So these are two
[31:12] wonderful questions. So the first answer is that we're
[31:15] looking into it. Okay. In 2017, we published the first study,
[31:24] brain imaging study, looking at women going through menopause
[31:29] 2017. The first it's not so offensive, is a woman, I think
[31:35] it's ridiculous.
[31:37] Dr. Mindy Pelz: I Oh, it's offensive, because we've never
[31:39] looked at a woman's brain this way. We've never done it before.
[31:42] Lisa Mosconi: How is that? How is that even possible? Every
[31:44] woman goes through menopause. And it just was not been studied
[31:50] using at least using brain scans. But I think I think the
[31:53] brain, you know, it's one of the most important organs that we
[31:55] have. And more than 75% of menopausal women really have
[32:00] neurological symptoms, from hot flashes and night sweats to
[32:04] brain fog and memory lapses. So I was like, well, so many people
[32:08] come to us so many women will come to us for our studies. And
[32:12] for the Alzheimer's prevention clinic, I need to be able to
[32:16] give them an answer. So I went and said, what's been done? You
[32:20] know, what do we know about the menopause brain? And the answer
[32:23] was basically nothing. All the studies that were done, there
[32:27] weren't that many studies to start with. In all the studies
[32:32] were done after menopause, but after by a long shot that women
[32:37] were low 70s or 80s, or late 60s. So we started looking into
[32:42] that. And so far still today, this is what 2020 For our
[32:46] studies. Thank goodness, I remember our study that the only
[32:50] studies that look at women over time, using brain scans. In will
[32:57] okay. We again is like geez, can we just kind of make this a
[33:01] priority? Please?
[33:03] Dr. Mindy Pelz: Agreed, because it's it's such a dramatic brain
[33:07] change that until you actually go through it. You can't put
[33:12] words to it. I mean, it's very difficult to explain. I
[33:15] Lisa Mosconi: completely agree, I completely agree. And now
[33:17] we're looking at all different aspects of this transition. And
[33:20] what we find is that the brain starts changing before the final
[33:27] menstrual period, during Peri menopause, or to the menopause
[33:32] transition, women go from having a period to not having a period,
[33:37] that is the most intense phase for brain rewiring and
[33:42] remodeling, then there's still changes as far as I can tell
[33:46] them this, there are still changes for about six years
[33:51] after the final master that here, and then it depends, we
[33:56] see and we obviously needs to be replicated, but at least we know
[34:00] something right? So what we see is that for some women, the
[34:03] brain eventually these changes can slow down. And then they
[34:08] kind of plateau. For some women, there's a little bit of a
[34:12] rebound. So you see more energy, you see more cellular energy
[34:17] production, you see a little bit of more even more volume in the
[34:21] brain in some parts of the brain. But then for other women,
[34:26] it keeps declining, right, the changes keep occurring. That's
[34:32] what we're trying to understand. There seems to be a family
[34:36] history component. So we work. The first study was all done on
[34:43] women who are at risk for Alzheimer's disease, because
[34:48] that's what I specialize in. Then we extended our cohort to
[34:53] women who do not have a family history of Alzheimer's. And so
[34:56] by comparison, we could say well, those who Do have a
[35:00] predisposition to Alzheimer's disease seem to be more likely
[35:05] to not stabilize, but to keep declining. And this is not
[35:09] universal is not 100%. But it was a higher chance. Okay,
[35:16] experiencing a continuous brain decline memory decline. And
[35:20] that's when we start talking about Alzheimer's prevention,
[35:22] because it's really important to do that. But overall, to answer
[35:26] your first question, it looks like this brain rewiring can
[35:31] take up to 15 years. Yeah, sometimes it's much faster. I
[35:37] don't know exactly what the average is. But I will say
[35:39] around seven or eight years, during which we see consistent
[35:44] changes for most women into studies as well. And now we have
[35:47] hundreds, I would love to have hundreds of 1000.
[35:52] Dr. Mindy Pelz: But yes, I would love you to have not to help me
[35:55] know how I let me know how I can assist you. I've we have lots of
[35:59] women that follow. Follow this podcast that you know, if you
[36:02] ever need more subjects, you let us know it's
[36:05] Lisa Mosconi: yes. In fact, I would like to talk to you about
[36:07] this. Maybe later, there are two studies that we're actively
[36:11] recruiting for. And yes, the first thing I do so your second
[36:15] question. Yeah. Before I forget
[36:18] Dr. Mindy Pelz: your menopausal rank? Yes, go for it.
[36:21] Lisa Mosconi: And then No, given it manifests, I've been closed.
[36:24] So no, no, sir. Okay, that's fine stone, if I'm preparing,
[36:30] I'm actually preparing, like, this is just a preview. I don't
[36:33] know, if taking hormones would change that. My My assumption is
[36:38] that it would just make the transition smoother, smoother,
[36:42] because the transition we look for, whether you take hormones
[36:46] or not. The point is they're hormone therapy may actually
[36:51] alleviate the symptoms, you want change the process, the process
[36:54] needs to happen, I think, right? But you have make it smoother,
[36:58] and make it easier for you for some women in this to go
[37:02] through.
[37:03] Dr. Mindy Pelz: Okay, so I thought I have on that is, if
[37:07] there is a pruning process that is necessary to to step into
[37:13] this new brain that you get postmenopausal Lee, that can
[37:17] serve you in so many ways. If I start and I'm not, I'm not pro
[37:22] or anti HRT, bioidenticals, I'm just, I feel like we've gone
[37:27] from a cultural hush about menopause to cultural chaos,
[37:31] where nobody knows what to do. So I really trust your opinion
[37:36] and want to, like get this clear for women. If you start adding
[37:40] in estradiol, or you start adding in, like, you know, an
[37:45] exogenous source, are you now slowing down the pruning
[37:52] process? Like, what if there's, I'm a little bit of what if you
[37:55] just need to rip the band aid off? Let the pruning happen? And
[37:59] then let the new brain grow? Or is it just you're gonna have a
[38:03] slower pruning process, but and a little less suffering, and
[38:08] you'll all will all end up in the same place? It's just a
[38:11] matter of, you know, it's not it's not speed, it's pain of
[38:16] going through the experience,
[38:18] Lisa Mosconi: right. So I, I cannot fully answer this
[38:22] question, because the research has not been done. But what we
[38:26] know from basic science is that the pruning will happen no
[38:31] matter what, because it's something that just needs to
[38:34] happen. There's a good reason for that to happen. However, it
[38:37] could, the effects are different, the perceived
[38:41] effects, the symptom, the quality of life changes, the
[38:45] severity of the symptoms may be alleviated by taking hormone
[38:49] therapy. Now while we are studying, which I think is
[38:52] fascinating, and hopefully in a couple of months, I can tell you
[38:55] more about what we're doing now. But the reason is that hormones
[39:02] alone don't really matter as much as the unit. So the
[39:09] hormones only work together with receptors, okay, and when we're
[39:15] born is women are brains and their bodies but really, our
[39:19] brains are full of estrogen receptors. We have a ton of
[39:26] estrogen receptors, which means that our brains are wired to
[39:29] respond preferentially to estrogen. Progesterone is
[39:33] important to start studying is important. Estrogen is really
[39:36] important based on the quantity of the receptors that we have,
[39:40] and how much they matter for a whole lot of things that need to
[39:45] happen inside your head. So when your estrogen concentration in
[39:51] plasma is low, the brain increases the number of
[39:55] receptors to balance it out. It's
[39:59] Dr. Mindy Pelz: it's like a horn medic stress, it makes itself it
[40:03] makes itself ready for the influx, it
[40:06] Lisa Mosconi: tries to grab it, right where your estrogen levels
[40:09] are higher, like during ovulation or close to ovulation,
[40:13] the brain doesn't need as many receptors, and so Sandbridge sap
[40:17] to just recede into interests. So once estrogen is just right
[40:22] is going to be imbalanced with a number of receptors. And that is
[40:27] optimal. So what we should be trying to do with hormone
[40:31] therapy with bioidentical estradiol, estrogen, the mother,
[40:35] the bio identical, whatever quality is that we might want to
[40:41] preserve the concentrations so that the brain doesn't have to
[40:46] change its activity too much.
[40:49] Dr. Mindy Pelz: Ah, so it doesn't doesn't these receptors
[40:53] don't have get out of balance?
[40:54] Lisa Mosconi: Yes, that's but we don't know. We don't know. We
[40:58] don't know. You know why that
[41:00] Dr. Mindy Pelz: would semester dial should be doing it until
[41:03] you research it,
[41:04] Lisa Mosconi: I do. Now I can talk to you about it. Because
[41:08] it's not just that we're doing it we're doing it we're working
[41:12] on. And what we're learning, you know, how hormone therapy is
[41:18] typically prescribed after menopause. Yeah, most providers,
[41:25] if you go to a provider, you say I still have a menstrual cycle,
[41:29] even though it may be once every few months in the head, the
[41:33] symptoms, they may or may not put you on hormones, or suggest
[41:38] that you take hormones, many doctors would prefer to wait
[41:43] until you are effectively menopausal. So to a month after
[41:48] the final menstrual period, what science says which I know
[41:51] there's a huge gap between science and clinical practice,
[41:55] it takes 17 years for the research to turn into a clinical
[41:59] recommendation, I know that from science, the right time, the
[42:04] best time to start taking hormones is before the final
[42:09] menstrual period is when your estradiol starts fluctuating
[42:12] because that's going to send your brain into a flux, just
[42:15] trying to keep up. Right. So we're studying that well. That's
[42:19] from basic science, we need to make sure that women's brains
[42:24] react the same way. So we're trying to measure that now. And
[42:28] we're also going to then do clinical trials to make sure
[42:31] that we can preserve the conversation. It's gonna take a
[42:33] minute, but we're coming to the red, hopefully,
[42:36] Dr. Mindy Pelz: 17 years, so we don't have 17 years. So you
[42:39] gotta get this. Yeah, yeah, that's what I
[42:41] Lisa Mosconi: said to you, everyone to the by the, by the
[42:42] time I start going through Peri menopause, I want answers.
[42:49] Excellent. You know, I want to know what to do. Great. So I'm
[42:52] working as fast as
[42:53] Dr. Mindy Pelz: I can. Okay, so it's self serving.
[42:57] Lisa Mosconi: But I also I also, I also really want to help other
[43:02] women, because there's so many women who really have a hard
[43:05] time doing none of us and there's no research, there's
[43:08] very little research, there's very little support, there's
[43:11] very little understanding, you know, we go through puberty, and
[43:15] it's it's a huge celebration. Oh, my God, you're a Drona is
[43:18] amazing. Yes, you go through you have you get pregnant, this baby
[43:23] showers. This picture has been taken. Everybody loves you. And
[43:26] it's such a one. You go through menopause and nobody cares. No.
[43:32] Dr. Mindy Pelz: You know, a statistic that really has
[43:34] grabbed me and has me searching for answers is that the most
[43:38] common time for a woman to commit suicide, the most common
[43:40] decade is between 45 and 55. That has to be because of the
[43:45] brain changes. And I've actually seen some research that shows
[43:50] there are the parts of the brain that actually initiate suicidal
[43:53] thoughts gets activated in and now I'm looking at this a little
[43:58] different, but in the menopausal transition, that part gets
[44:01] activated.
[44:02] Lisa Mosconi: Oh, no. I think it's so it's so imbalanced, you
[44:05] know, some parts of the brain become stronger, we're more
[44:09] protected. And that's done at the expense of other parts of
[44:14] the brain. Right? Like what you're saying, there's, it's
[44:17] very clear to me, at least neurologically that menopause
[44:21] does not cause disease does not make you do things, but it does
[44:27] increase vulnerability to whatever predisposition you
[44:31] have. So if you have a predisposition to depression,
[44:35] it's very likely that you may experience depressive symptoms
[44:39] or receive a diagnosis of clinical depression. As you go
[44:43] through menopause. If you suffer from anxiety, you may get panic
[44:46] attacks for us in neurology, multiple sclerosis, you know the
[44:52] sign the lesions in the brain tend to become clear. During
[44:57] these transition states, the US timers plaques. We see them very
[45:02] clearly when women start missing their cycles in perimenopause,
[45:07] that's when we find the red flags for Alzheimer disease in
[45:11] women with a predisposition to outside, right. So menopause is
[45:14] a little bit of an activator, if you will, whatever medical risks
[45:20] you have, are likely to make an appearance as you go through
[45:25] menopause. So it's a little bit of a preview for the rest of
[45:29] your life, what's
[45:29] Dr. Mindy Pelz: coming down? Yeah, so So I, in my research of
[45:34] trying to figure out what was going on with my own brain,
[45:37] because my brain in general, I'm 54, I've been postmenopausal for
[45:41] about a year and a half now. And the way I did I was, I should
[45:46] have thrown myself a party, I didn't think about that. I was
[45:49] too busy writing books. So So but what I the way I can
[45:53] describe it is that all of a sudden, my brain felt raw, I
[45:57] could not handle the stress that I used to be able to handle, I
[46:01] couldn't put in the work day that I used to be able to put in
[46:04] I sleep, of course became difficult anxiety and depression
[46:09] showed up for no reason, there was nothing that I can point of
[46:12] my finger at. So after a, you know, a few, like a year or so
[46:15] of that, I realized that something was shifting. And so
[46:19] of course I you know, I'm the one who loves to read the
[46:22] research that that people like you do. And I landed upon this
[46:26] really interesting study that talked about how estrogen
[46:30] progesterone, and mainly those two, that they actually also
[46:35] stimulate a whole set of neurotransmitters. So with
[46:39] estrogen estradiol, specifically stimulating dopamine and
[46:42] serotonin, acetylcholine glutamate, GABA, BDNF. And so I
[46:47] started looking at this, like, oh, it's like a shedding of a
[46:51] neuro chemical armor. It's like there is this neuro chemical
[46:55] armor that has protected us from our stressors, and has given us
[47:00] this superpower to be able to multitask and connect with other
[47:04] humans. It's coming down. And as it comes down there, we can
[47:10] either curse it, or we can say there's an opportunity here to
[47:14] do exactly what you're saying. If we How about we it's time we
[47:18] handle our traumas, how about we look at a deeper look at our
[47:23] relationships through a deeper lens? And what relationships
[47:26] need to stay and maybe what relationships need to go. Maybe
[47:30] we need to look at what our career path or what's coming
[47:34] down in the next you know, as Jane Fonda calls it our third
[47:38] act like it's an opportunity because this neuro chemical
[47:42] armor comes down and then there's a rebirth of something
[47:47] new. Would you would you say clinically like or from a
[47:51] Research Lens? Do you agree with this neuro chemical armor
[47:55] theory?
[47:56] Lisa Mosconi: I love it. And I think you're coming up with like
[47:59] the best analogy. Graduate is pearls of wisdom. Yeah. So what
[48:06] would estradiol does primarily, it's, it's actually it's a
[48:10] growth hormone, in many ways, you know, it was so it was
[48:14] discovered in the 1930s. By scientists, they were studying
[48:17] reproduction and fertility. And so immediately it was done. You
[48:21] know, with dog this is sex hormone. And we've been stuck
[48:24] with this definition forever. But in reality in 1996, in the
[48:28] 1990s, brain scientists realize did the same hormones that are
[48:34] involved in having children or not having children are also
[48:37] just as equally important for the functioning of our minds and
[48:41] their brains. And estradiol, in particular is the master
[48:45] regulator of women's brains. Because it's a little bit
[48:50] estradiol is to the brain with fuel is to an engine or to a car
[48:56] and yep, if you look and neurons will be estrogen receptors are
[49:02] extradiegetic flows riding hits the receptors in that activates
[49:07] a whole cascade the cellular event where energy production is
[49:13] improved. Okay, as tradeo pushes your neurons to make energy and
[49:20] water right, faster and harder. So that will mean that you have
[49:24] more serotonin, you have more dopamine, you have more
[49:27] glutamine glutamate conversion, and you have all these beautiful
[49:30] things happening inside your brain. And then it's Estrada,
[49:33] you recedes, we lose these activation effect, and the brain
[49:38] is doing recalibrate and start burning other sources of energy
[49:43] instead of glucose or in combination with glucose to
[49:46] support cellular energy. So this this is a big shock to the
[49:50] system in many ways, and it's indeed puts women at risk for
[49:56] suffering more from the effects of stress There's a lot less
[50:00] Yes, the aliens to stress. We just got published this study
[50:04] that I'm very proud of, we show that cortisol levels, right with
[50:10] cortisol in serum is a marker for chronic stress, predict the
[50:16] amount of cellular Alzheimer's plaques in the brain are
[50:20] correlated with lower gray matter density in the brain and
[50:26] lower brain energy levels, especially in women, and
[50:31] especially in women who are postmenopausal. So it's really
[50:35] important to keep that in mind. Also important because stress
[50:40] release, I really stress reduction should really become
[50:45] part of the menopausal toolkit. Yes, I would say
[50:49] Dr. Mindy Pelz: yes. Okay. So and that I only discovered by
[50:54] powering through my Peri menopausal years. And really, I
[50:59] mean, I ate well, I changed my exercise, I tried to sleep when
[51:03] I could, like I repaired my microbiome I detoxed in my 40s.
[51:09] The one thing I could not get a hold of was the I call it the
[51:13] patriarchal pace, that pace of production where you're like,
[51:17] keep going, keep going, you know, you're you're having to do
[51:20] so much. And so stress stayed high. And it hasn't been until
[51:24] recently when I really just put my foot down and said, Okay, now
[51:27] I'm going to handle stress, that I all of a sudden felt like my
[51:31] brain started to come back online. And I think that is not
[51:35] emphasized enough is how cortisol and chronic cortisol is
[51:41] really before we even think of lathering ourselves with all the
[51:44] creams or putting patches on, we have to think about what how are
[51:49] we going to manage stress?
[51:50] Lisa Mosconi: Yeah, because trance, I mean, in the end, that
[51:52] really syncs your hormones as well, right? So satis hormones
[51:56] and stress hormones are produced at the same time from a common
[52:01] precursor, this CO pregnenolone. And so the body needs to make
[52:04] more cortisol, it will take the pregnenolone away from the
[52:08] estrogen. Yep. And so more cortisol, less estrogen. So I
[52:13] think it's really important to balance the two. And to your
[52:16] point before, there's research, especially from Europe and Asia,
[52:22] showing that generally, once you're past menopause by about
[52:28] six years or more, the reason any increase in life
[52:32] contentment, and there's a renewed sense of energy,
[52:37] impossibilities, and it's a good time for many women to really
[52:41] enjoy their lives a lot more than that. Yeah. And that seems
[52:46] to be statistically significant. And you know, the
[52:48] anthropologist, Dr. Margaret man, she used to call and she
[52:52] used to talk about the menopause and zest, that once you're done
[52:56] with menopause, there's this renewed interest in life, and
[52:59] you feel like you have a new, you just there's a different
[53:03] Park in your eye and you you have a different way to approach
[53:07] life. And there's so much to look forward to. And I know that
[53:11] this is not universal, I know that many women just suffer
[53:14] throughout menopause and beyond. But I think it's also important
[53:18] to realize that this is not universal. And that naturally,
[53:23] more women do not tend to report an increase in life contentment,
[53:31] once they're a little bit older. So I think there's plenty to
[53:34] look forward to and to really, yes, set your mind towards, you
[53:38] know, you want to set the tone for the rest of your life. Yeah.
[53:43] And I think if there's power, our minds are powerful, and
[53:46] there's power in our choices. And the mindset also plays an
[53:51] important role that we don't talk about that much.
[53:55] Dr. Mindy Pelz: I love that. Because if you think about let's
[53:58] think about the 35 year old or the 40 year old who's like,
[54:02] starting to embark upon this Peri menopausal journey, and has
[54:06] heard about all the suffering, yeah, all this like you. But you
[54:10] know, I have so many of my friends that are 10 years
[54:13] younger than me, they're like, Thank God, Mindy, you've already
[54:16] been through it. So you can turn around and like, help us through
[54:19] it.
[54:19] Lisa Mosconi: Absolutely.
[54:20] Dr. Mindy Pelz: We've gone from again, not talking about it to
[54:24] now everybody's talking about it, and they're scared about it.
[54:28] And I think the next place I would love to see the
[54:30] conversation go to is this is preparation of cultural
[54:35] leadership. This is an opportunity where you can
[54:39] actually step into the most authentic version of yourself,
[54:44] and you may end up the back half of your life, this may be the
[54:47] most joyful time that you've ever experimented or ever
[54:51] experienced with. So now if I'm 42, and I'm depressed or I can't
[54:56] hold on to memories, or that suicidal part of my brain is has
[55:00] been activated. If I have a vision of where what my brain is
[55:05] doing and where I'm going, that's a thread of hope that so
[55:08] many women can now hold on to as they go through this time. It's
[55:13] almost like pregnancy and birth, like you're birthing a new
[55:16] brain, and then you're gonna have to push it out, and then
[55:19] you get the reward. Yes,
[55:20] Lisa Mosconi: I love this way of thinking about it. For me, as a
[55:25] scientist, I've never been scared of menopause. I've never
[55:28] been scared of pregnancy, I just know what happens and why
[55:31] happens. And I think it's so important to, to just spread the
[55:36] word and share the knowledge so that yeah, it doesn't feel
[55:41] alien, when it happens. Because I think a lot of the reasons
[55:44] that women have women may have such a hard time during
[55:48] menopause is just you don't know what hit you. Because you're not
[55:51] prepared for it. And it feels like somebody just pulled the
[55:55] rug out of you, and you feel blindsided by your body and let
[56:00] down by your doctors, and you just don't know what to do or
[56:03] how to take care of yourself. So I think it's really important
[56:06] to, first of all, understand the science and be familiar with the
[56:11] science and also the terminology if I may, and then look at
[56:16] solutions, right? What are what are all the things that can make
[56:20] this transition better, and gentler and easier? And what
[56:24] kinds of solutions would work for you as an individual? And
[56:28] there's no right or wrong answer. So I'm also not pro HRT,
[56:33] I am pro solutions, and they most certainly encase suffering,
[56:38] right? There's no need to suffer? Yes, it's a long
[56:42] transition, it can take a long time. So I would say, let's look
[56:46] at all the solutions, maybe something will work now. And
[56:48] then we'll change to something else later. But let's just be
[56:52] informed about all the things that can actually work and then
[56:55] come up with a plan that works for you. And for me, again,
[56:59] because I am a scientist, it's important to share the right
[57:03] words with women, because we're then we're they noticed, coming
[57:08] into this field a little bit from the back door, in a way is
[57:12] that menopause is really portrayed as a medical
[57:16] catastrophe. Like you look, you open a textbook and medical
[57:20] textbook and menopause in western medicine is defined as a
[57:25] state of estrogen deficiency caused by ovarian failure. Oh,
[57:33] how is that going to make you feel? Oh, great. You know,
[57:39] that's me. Is there more? And then there are experts or other
[57:44] people who are like, Well, no, no, no, let's take a step back.
[57:47] This just the scientific definition is based on mice,
[57:50] that's just considered menopause as part of the natural aging
[57:54] process. And that's also being a little bit out of touch with
[57:58] reality, there's nothing natural about it. And that feels like
[58:03] you should just kind of ride the wave and do nothing, because
[58:06] it's just natural. And so the correct definition of menopause
[58:11] is a neuro endocrine state or a neuro endocrine transition,
[58:15] where your body where your brain and your ovaries and your
[58:19] hormonal system are changing at the same time. So this is a
[58:23] biologically programmed event, which needs to happen, however,
[58:28] is not part of chronological aging. It's endocrine aging,
[58:32] which is different. It sounds that the pros and cons were the
[58:37] concert of yours. There are sentences, they have flashes of
[58:40] brain fog. But there's also pros in the process that this is this
[58:44] is needed for you to transition to a different phase of your
[58:48] life where you have just just a completely different biology.
[58:53] Right. So let's use this terminology. Menopause is not a
[58:57] disease, we do not need to treat it as such, because it's not a
[59:01] disease. You don't have to necessarily medicate it unless
[59:05] you find relief in prescription medications, which is great if
[59:10] you do wonderful, but let's let's not start with a mindset.
[59:13] This is something that's making you sick. Yeah. All right,
[59:17] because it's very disempowering, I think. Agree. Yeah. And it's
[59:22] not saying you shouldn't use medications. It's more just
[59:27] saying, let's take home. You know, this is not making you
[59:30] sick or not dying. Yeah, but let's look at solutions. You
[59:35] think it's a better what do you think?
[59:37] Dr. Mindy Pelz: Do you think I love that? Because I think one
[59:40] of the chat one of the things that I've been really trying to
[59:42] emphasize to my followers is there's not one solution.
[59:47] There's your solution. Yeah. And so you've got to find your
[59:52] rhythm with these changes that are going on in your brain and
[59:56] your body as you go through the menopausal experience. And I
[59:59] think I think one of the places we start deceiving women, is
[1:00:03] when we're like, everybody needs to put a patch on, everybody
[1:00:07] needs to do bioidenticals. And then a woman tries it, and all
[1:00:11] of a sudden, maybe she gains, you know, 20 pounds, or another
[1:00:14] woman tries it and she becomes suicidal. Like, we have to, I
[1:00:19] think that the way, what you just said was so powerful. And
[1:00:22] then I feel like we need to take it even deeper and say, and your
[1:00:26] goal as you go through this experience is to find your
[1:00:29] menopausal toolbox. And you might sometimes need to pull out
[1:00:33] a patch. And other times you may need to get rid of the alcohol.
[1:00:37] It's like there has to be a set of tools that you're given. And
[1:00:42] then you need to learn how to use those tools as you go
[1:00:45] through the experience. Yes.
[1:00:46] Lisa Mosconi: And in the end, you do you, you know you are the
[1:00:51] expert when it comes to your health and your well being. And
[1:00:56] it's wonderful to know with things that have helped other
[1:00:59] women, that's obviously a wonderful starting point. But in
[1:01:02] the end, unfortunately for menopause, it's a little bit
[1:01:05] trial and error. And I think the reason that this is the case is
[1:01:11] that we do not have an integrative framework for men of
[1:01:15] yours. If you think about it, you're going through menopause,
[1:01:17] and you're experiencing the hot flashes and you're experiencing
[1:01:20] the brain fog. Maybe you can't sleep at night. Who do you go
[1:01:23] assume you go to an OB GYN, an OB GYN specialist, wonderful,
[1:01:29] but doesn't do brains. Right. They're not trained. I mean, not
[1:01:34] there's not a critique in any way, shape or form. They're
[1:01:37] wonderful specialists. But they're not trained to manage
[1:01:41] brain health. They're not trained there or they don't
[1:01:44] specialize in the brain. And it's really, I think, a missed
[1:01:48] opportunity. The brain specialists are not involved in
[1:01:53] a woman's medical checkup when it comes to menopause care.
[1:01:57] Because we do have something to bring promise we bring a lot to
[1:02:00] the table. We can really support women through this transition.
[1:02:04] And it's wonderful to work with her colleagues in OBGYN so that
[1:02:09] and also preventative cardiology, and metabolic health
[1:02:13] and sleep everybody. It would be wonderful to have a more
[1:02:17] integrative approach with all different specialties are able
[1:02:20] to weigh in as needed. To address a different point, yeah,
[1:02:24] it's a dream. We do this actually Weill Cornell medicine,
[1:02:28] where we collaborate with our colleagues in OB GYN, also OB
[1:02:32] GYN surgery. Because Leesy surgical menopause is a little
[1:02:37] bit harder on the board or can be harder on the body and the
[1:02:40] brain. We work with our colleagues who specialize in
[1:02:44] breast cancer and reproductive cancer. So they were all
[1:02:48] together. And what they do is that they send their patients to
[1:02:52] us for cognitive testing when necessary brain imaging, and all
[1:02:57] these evaluations that we do for cognitive health and brain
[1:03:01] health. And the other way around our patients once we figured out
[1:03:06] okay, these problems you're having are much more likely to
[1:03:10] be menopause than Alzheimer's disease. For example. Let's go
[1:03:13] talk to our colleagues in OB GYN and see what they recommend for
[1:03:17] a treatment plan. And then let's try everything together. So I
[1:03:21] think this this is so
[1:03:23] Dr. Mindy Pelz: beautiful. I wish everybody operated like
[1:03:25] that. What do you think? Where do you think lifestyle fits into
[1:03:28] this? Like, how important is your lifestyle as you're going
[1:03:32] through? I'm going to start calling it the pruning process
[1:03:35] called perimenopause, it should be called the brain, the brain
[1:03:39] pruning process.
[1:03:41] Lisa Mosconi: Yes. And I think it's interesting that we define
[1:03:44] a brain process based on the ovaries. Right, we completely
[1:03:50] disconnect. We don't acknowledge the fact that the brain is
[1:03:54] involved in menopause, everything is always based on
[1:03:57] the function of the ovaries, which I think is confusing to a
[1:03:59] lot of patients as well, because they don't really match your
[1:04:02] experience. But anyway, I think lifestyle is very important.
[1:04:07] It's really your foundation, and is your starting point for
[1:04:10] health. And the healthier you are as you go through menopause,
[1:04:15] the less likely you are to have severe symptoms or discomfort.
[1:04:20] And of course, it's not a 100% correlation. But there seems to
[1:04:24] be any impact. Things like regular physical activity, a
[1:04:29] healthy diet or a balanced diet, stress reduction, sleep,
[1:04:33] hygiene, avoiding toxins, regular medical checkups, those
[1:04:38] are all things that just support health overall, and do support
[1:04:44] Hormonal Health as well. So they are I think they're very
[1:04:46] important. You
[1:04:48] Dr. Mindy Pelz: know, if I go back to the grandmother
[1:04:50] hypothesis, one of the things I was thinking about when you were
[1:04:53] talking about the purpose of the grandmother in back in the
[1:04:56] primal days, how if they didn't come back with a kill Then they
[1:05:01] had to take what they had forged close by to the cave. And that
[1:05:05] was probably plant based. Yeah. So if you if you look at what
[1:05:09] the diet for the perimenopause menopausal woman, I would think
[1:05:15] it was probably a mixture of definitely some animal meat, but
[1:05:19] you didn't have access to that all the time. So it also is
[1:05:22] probably very much a plant based diet. And what I've seen as much
[1:05:26] as there's incredible conversation around protein
[1:05:29] right now and the need for more protein, which I agree with, I
[1:05:33] also think equally for the menopausal woman is the need for
[1:05:36] plants, because it just off the grandmother hypothesis.
[1:05:41] Sometimes grandma had to go get the plants and bring it back.
[1:05:44] Right. And that's what we all maybe it's not just menopause,
[1:05:47] maybe it's all ages of female reproductive cycling,
[1:05:51] Lisa Mosconi: I would say then, most of the research shows that
[1:05:56] a plant forward diet seems to be really beneficial for women's
[1:06:01] health. Overall, I love that, which is a flexible diet, and
[1:06:07] really is focused on getting the nutrients in Yep. Great, you can
[1:06:13] get a lot of good nutrients from eating plants. And then like you
[1:06:16] said, you know, meat and fish and higher protein sources can
[1:06:21] be helpful as well. But it's also good to know that you can
[1:06:24] get a lot of nutrients from eating plants, because really
[1:06:29] the strongest correlations I have seen are with fiber, and
[1:06:35] women's health and talk. Yeah, hormonal health and women's out
[1:06:38] is really fiber. And you were talking about balancing your
[1:06:40] microbiome before. Yeah, antioxidants seem to be super
[1:06:46] important. Why? Because the brain and the ovaries are
[1:06:49] extremely metabolically active. Oregon's and the more
[1:06:53] metabolically active you are, the more sensitive you are to
[1:06:56] free radicals and oxidative stress that are very damaging to
[1:07:01] cells. And the only way to reduce oxidative stress is by
[1:07:06] importing antioxidant nutrients from your diet. Yeah, so those
[1:07:11] have to happen. And that's the you know, for the microbiome,
[1:07:13] something that was really interesting to me is how a part
[1:07:17] of the biker, or the microbiome is called the Stroebel on. Yes,
[1:07:21] Dr. Mindy Pelz: I love this part, this is my favorite part.
[1:07:23] Tell me what you know about it. It's
[1:07:25] Lisa Mosconi: so cute. I mean, you might just the term there's
[1:07:29] a collection of bacteria and micro organisms in the
[1:07:33] microbiome that are part of this trouble on and this is this
[1:07:38] sector of the microbial population that is very
[1:07:41] specifically involved in regulating estrogen levels, by
[1:07:46] deciding whether the estrogen needs to be expelled from the
[1:07:50] body eat out or not, or needs to be reintegrated in the
[1:07:54] circulation. And the way so it's important to have a healthy
[1:08:00] struggle on to make sure that your estrogen levels are import
[1:08:04] balanced. They're not the only determinant. They're still being
[1:08:07] studied, but they do seem to play a role. Now, how do you
[1:08:10] keep them healthy by consuming a plant rich diet that includes a
[1:08:17] lot of fiber oligosaccharides, antioxidant, nutrients,
[1:08:22] prebiotics, probiotics, so that's another reason to consume
[1:08:27] more plants. You know, like we were saying before, I'm not pro
[1:08:30] HRT, I'm not pro any specific diet, I am pro diet that works
[1:08:35] for you that is sustainable for you, as long as it's healthy and
[1:08:39] really is well rounded, includes a diversity of plant based
[1:08:44] foods, because those are good for health. It's good to have
[1:08:46] diversity when it comes to the phytochemicals and
[1:08:49] phytonutrients. And that is sustainable, so that there's no
[1:08:53] okay. I'm vegan for three weeks, and then I'm gonna go keto
[1:08:57] because they gain weight or the other way around. That is much
[1:09:01] more disruptive to keep switching diets or keep, you
[1:09:05] know, the yo yo dieting or Yes, so the ranges and anything is
[1:09:09] confusing to your body. Yes. So I think whatever diet is
[1:09:13] sustainable for you, that is high, the nutrient dense diet.
[1:09:19] Yep, I support you.
[1:09:22] Dr. Mindy Pelz: You know what, you you're the first person I've
[1:09:24] talked to that has a very similar approach to diet that I
[1:09:28] because I feel like there's a lot of good in all the
[1:09:31] conversations we're having around diet right now. The only
[1:09:34] one I'm opposed to is the standard Western diet, that's
[1:09:37] chemicals and inflammatory oils, so that you have to figure out
[1:09:41] what diet works best for you. And we when we become dogmatic
[1:09:46] and we're like you eat this way, you don't eat this way. Now I
[1:09:50] feel like we've lost our way. We need to look at all the
[1:09:53] different diets maybe keto is better for you. Maybe it's not
[1:09:56] maybe vegans better for you. Maybe you need to do the
[1:09:58] carnivore diet for a few weeks. I mean, let's look at all of
[1:10:01] them, and like, see where they may fit. And you figure out what
[1:10:05] works best for you. So I just didn't take a more holistic
[1:10:10] approach to do than we're doing right now. So,
[1:10:15] Lisa Mosconi: I mean, honestly, in the end, if you're able to
[1:10:18] just eliminate processed foods from your diet, at that point,
[1:10:24] whatever diet you're own is a matter of optimization. Yeah,
[1:10:29] but the base is solid. So if there's one recommendation that
[1:10:34] we could give to people that's religious try to stay away from
[1:10:37] processed foods, highly processed foods, especially fast
[1:10:42] food, packaged foods with a ton of preservatives, once those are
[1:10:46] out of the diet, then, you know, you're basically halfway through
[1:10:52] if not more than that, yes. Yeah. Amazing.
[1:10:55] Dr. Mindy Pelz: So before we close, I do have to ask you,
[1:10:57] then what do you think of fasting? Where do you think
[1:11:00] fast, if I do it fast, I could Girl.
[1:11:07] Lisa Mosconi: Girl, better I have. So surprisingly enough, I
[1:11:12] have been unknowingly practicing intermittent fasting or sort of
[1:11:17] intermittent fasting for my entire life. Because I was born
[1:11:22] and raised in Florence, in Italy. I studied in France for
[1:11:27] high school. So in Europe, where it's very common to have a light
[1:11:32] dinner earlier in the evening, especially my parents that you
[1:11:38] met very early, like six 7pm already. And then that's it
[1:11:42] until eight in the morning. So just naturally, we are raised to
[1:11:47] go for at least 12 hours without any food, a great daily upgrade.
[1:11:52] And I've been doing this for my entire life. I haven't tried to
[1:11:56] go like 14 1516 hours, but I have no problem doing that, like
[1:12:00] I seen. If I need to go for a blood test, right, and my
[1:12:04] appointment is at 11 or 12. I don't need to eat. I'm quite
[1:12:08] nodding. So I think that my body's kind of comfortable with
[1:12:13] the idea that you don't have to constantly eat. And it makes a
[1:12:17] lot of sense to me because you need to give your liver a break.
[1:12:20] Just have right. You can't keep munching and snacking and the
[1:12:23] midnight free drawn into it just a healthy practice. So that's
[1:12:29] where I'm, I also would love to summer research.
[1:12:32] Dr. Mindy Pelz: But here's what I would love you to research. I
[1:12:36] would have put it on you. Since I have direct access to you, and
[1:12:42] this is the ketone. So if you look at what the ketone does in
[1:12:48] the studies that I've seen, one of the things that is that as
[1:12:50] the ketone, you switch over into this ketogenic energy system,
[1:12:54] what the ketone brings with it is GABA. So actually, the more
[1:12:59] your ketones start to kick in not I'm not talking about
[1:13:02] ketoacidosis. I'm talking about a short small bursts of ketones,
[1:13:06] you now have a little more GABA, okay, that's really helpful to
[1:13:10] the menopausal woman who's losing progesterone and is
[1:13:14] feeling anxious all the time. And the other thing, that key I
[1:13:19] see where I'm going with this, the other thing that ketone
[1:13:20] does, is it up regulates BDNF. Well, that's really helpful for
[1:13:26] when I'm losing Astra diawl, who was also up regulating BDNF. Now
[1:13:31] she's gone. Could I use my own internal ketogenic energy system
[1:13:35] with cycling in small bursts of fast to get these ketones to
[1:13:40] come in and create a neurochemical change? That is
[1:13:44] going away because my hormones are starting to diminish as
[1:13:47] well.
[1:13:48] Lisa Mosconi: So I should point you to the research of my
[1:13:52] colleague, Dr. Roberta Diaz Brinton has done a lot of
[1:13:56] research on this. And she has shown that indeed, the
[1:14:00] postmenopausal brain is higher in ketones and fatty acids,
[1:14:06] better oxidation in response to the changes in estradiol. So
[1:14:11] estradiol is a glucose loving hormone, okay, so for as long as
[1:14:18] your estradiol levels are high in your brain, which is not 100%
[1:14:23] dependent on the ovaries because the brain also makes us to dial
[1:14:26] in house. Right? But as long as there's enough estradiol in the
[1:14:30] brain than the brain runs on glucose. When Esther Dahlia
[1:14:35] withdraws, then there's this switch in the way that the brain
[1:14:39] metabolizes energy or produces energy or send you a scented
[1:14:43] paper. It's really beautiful. It's a beautiful,
[1:14:45] Dr. Mindy Pelz: I'd love to see
[1:14:47] Lisa Mosconi: where, first of all, there's an increase in
[1:14:51] better oxidation so the brain starts burning fat. Then there's
[1:14:55] an increase in ketone body production. When they say In
[1:15:00] Time disease, there is a reduction in oxidative
[1:15:02] phosphorylation. Now all this work is done in animals going
[1:15:08] through menopause, why these animals experience is a first
[1:15:17] stabilization in energy levels that eventually leads to a
[1:15:21] crash. So that's not good news. No, right? Let's not do that.
[1:15:27] However, mice are not women. Mice are not supposed to outlive
[1:15:32] menopause women are. So I would be really interested in seeing
[1:15:36] how this research translates to women's brains. And we're trying
[1:15:40] to do that now. Together, we work together. So that's really
[1:15:43] wonderful. And maybe at some point, we'll give you a better
[1:15:47] answer. But for now, we do know that there is an increase in
[1:15:51] ketone metabolism in the brain. Yeah, it is not necessarily diet
[1:15:56] correlated is internal. In the brain. We don't quite know the
[1:16:00] consequences of that in women.
[1:16:03] Dr. Mindy Pelz: So so the way I would translate what you just
[1:16:06] saw me for the, for the postmenopausal woman, the brain
[1:16:11] could favor ketones, it could actually be uh, you know, take
[1:16:15] some pulses of ketones.
[1:16:16] Lisa Mosconi: I wouldn't say favorite, the brain has to
[1:16:18] switch to ketones.
[1:16:21] Dr. Mindy Pelz: It okay, it's necessary. Okay. So yeah, and I
[1:16:23] don't because then people will get people
[1:16:25] Lisa Mosconi: are gonna think, Oh, we really want as ketone
[1:16:27] body. We're on a keto diet are sensitive. Yes. Well, more
[1:16:32] sensitive has to switch. It has to switch. So before it was
[1:16:36] running on glucose, and now the glucose is kind of reduced. We
[1:16:41] need to switch to an alternative energy source. Yeah, yeah, we
[1:16:45] become a hybrid. The brain becomes more of a hybrid.
[1:16:50] Dr. Mindy Pelz: Yeah. That I mean, like a hybrid car. I see
[1:16:52] that all the time. Yeah. So which is kind of how I found
[1:16:56] fasting was in those Peri menopausal years when the brain
[1:16:59] fog kicked in, I realized at certain points of my cycle, is
[1:17:03] that if I actually fasted, all of a sudden I had mental
[1:17:06] clarity, it came back online. That's so it was all in my Oh,
[1:17:10] and then I noticed it with my patients and my online community
[1:17:13] the same way. So now again,
[1:17:15] Lisa Mosconi: to do a clinical trial of that, because they
[1:17:18] efforts, yeah, many women come to me and say, you know, now
[1:17:21] that I'm doing fasting, my brain is kind of coming back to life.
[1:17:26] You know, that's right. And I was like, Yeah, tell me, I would
[1:17:29] love to study that more in depth. We can say find, please.
[1:17:33] We have a lot of basic science. A lot. We have some basic
[1:17:37] science done. But the studies in humans, especially women, who
[1:17:41] are not the bees, were not athletes. We need more, we just
[1:17:45] need more, right? Yes, we need what's happening because it
[1:17:49] could be a really wonderful tool. Yes, and we've studied.
[1:17:55] But if I do, I don't call you.
[1:17:59] Dr. Mindy Pelz: I will I will send all the men of
[1:18:01] postmenopausal Peri menopausal women, I'm sure those of them
[1:18:05] listening right now will say a hell yes to that. Because what I
[1:18:10] love is the power of the ketone is its internal resource you can
[1:18:15] tap into. And we really need to be thinking about free ways to
[1:18:20] help women, it can't always be an expense. And what I love
[1:18:25] about fasting is if you learn how to cycle fasting, it is
[1:18:28] completely free. You just need women need to know how to do it
[1:18:32] for their hormones. And, and in all the research I've seen, we
[1:18:35] don't have enough research on women, and we definitely don't
[1:18:39] have enough on post and postmenopausal women. So so I'm
[1:18:43] going to I'm going to tasked you with doing that. So anyways,
[1:18:48] Lisa, this is thank you for giving me so much of your time i
[1:18:52] i have to tell you, this is one of my favorite conversations
[1:18:56] that I've had in such a long time because what I've asked you
[1:19:00] are questions I've been asking myself and I have been trying to
[1:19:04] find answers to I was one of the the fans that ordered this book,
[1:19:09] the minute you put something out about it. I was like, I want
[1:19:12] this book, I got to get this bug. And the minute it came to
[1:19:15] me I scoured through looking for all my answers. And so what a
[1:19:18] delight for me to be able to have this conversation with you
[1:19:21] is just real treasure on a personal level. So thank you so
[1:19:26] Lisa Mosconi: much. And you know, you really make it fun.
[1:19:29] Thank you promise me as well. And thank you, I really, really
[1:19:35] appreciate it and just the opportunity to talk to you and
[1:19:40] your followers into women and just share the knowledge and
[1:19:44] bring the science out of the lab is extremely. It's just
[1:19:48] wonderful. And I thank you for that.
[1:19:51] Dr. Mindy Pelz: Yeah, it's like we're all necessary in the
[1:19:52] conversation, right? Like, we need all of us to be opening
[1:19:57] this up and having this beautiful conversation so that
[1:20:00] We women feel heard? I think that's the most important even
[1:20:03] if we don't have answers. Yeah,
[1:20:05] Lisa Mosconi: so I'm not for sure. And also that the recent,
[1:20:08] it's not black and white. I don't spend a lot of time on
[1:20:12] social media. But when I do sometimes it's a little bit
[1:20:14] daunting because I go, Oh, my goodness, did you just say the
[1:20:17] grid? And I find it very intimidating. Like, if I
[1:20:22] approached this as, not as a scientist, or researcher, I
[1:20:27] would be very confused, and perhaps a little scared, because
[1:20:31] it thinks that you're here. So I think it's important to have a
[1:20:34] more balanced conversation where, yes, obviously, menopause
[1:20:38] is no picnic. Right? And we need to speak to that. And the
[1:20:42] knowledge, women have been reporting for 1000s of years
[1:20:45] that we need support, there has to be more pharmaceutical
[1:20:49] development, there should be more research looking at
[1:20:51] lifestyle and behavioral interventions as well. But it's
[1:20:55] so so good, then. I think it's good to know that it's not doom
[1:20:59] and gloom. And then there's a positive, much more positive way
[1:21:04] to think about this life change, intervene accordingly, right,
[1:21:08] nobody should suffer. But at the same time, keep an open mind and
[1:21:12] the positive attitude, because in the end, most women spend a
[1:21:16] third of their life in a postmenopausal stage, we can't
[1:21:20] approach it is something we don't want. That's
[1:21:24] Dr. Mindy Pelz: right. So well said. Okay, I have to finish up
[1:21:27] on this question. I could talk to you all day. I always asked
[1:21:33] every guest because I think that we often don't have language to
[1:21:37] what health is. So we all have our own personal language. So
[1:21:41] what does health mean to you? And you've already spoken of
[1:21:45] some of your health goals. Do you have any health goals for
[1:21:48] yourself that you're currently working on?
[1:21:50] Lisa Mosconi: So many? My husband thinks I'm nuts. I just
[1:21:54] as I go through the research, I'm like, Okay, I'm going to
[1:21:59] enter perimenopause soon enough, I suppose. I want to be
[1:22:04] prepared. I want to do everything I possibly can to
[1:22:07] make it easier on myself and on him. You know, we have, of
[1:22:11] course, yes. Yeah. We have a realization like, yeah, yeah.
[1:22:15] It's also my daughter is probably going to go through
[1:22:17] puberty when I go through period. So it's important that
[1:22:21] we support him in that. So yes, I mean, for me, health is just
[1:22:27] being healthy, being comfortable in my own skin, I feel like I
[1:22:31] have the energy to do things. And I look forward to just
[1:22:34] waking up in the morning and living my life. You don't have
[1:22:37] to worry about oh my god, I can't do this because I'm not
[1:22:40] feeling good. Or I can't go there because I have a headache
[1:22:42] or I don't want to feel limited. So how being healthy is the way
[1:22:47] to be free. And freedom is really important to me physical
[1:22:51] and intellectual. So well said I love it's an investment. I
[1:22:55] think, you know, health is wealth, but also brain health
[1:22:58] really is the ultimate treasure, at least for me. So I really
[1:23:03] optimized for brain health. And I come from my last two years
[1:23:08] have been really demanding, like I've been working 5060 hours a
[1:23:13] week. I don't really I remember my last lunch break was in April
[1:23:19] 2021.
[1:23:21] Dr. Mindy Pelz: Oh, my God.
[1:23:24] Lisa Mosconi: Yeah, I mean, I eat obviously, but in a hurry.
[1:23:27] Like I mean, an actual lunch break when I'm not working. At
[1:23:31] the same time. We're not talking about work, it isn't. So my goal
[1:23:34] is to, to really engage in more self care and find some time for
[1:23:40] me more and for my family members to have a more balanced.
[1:23:45] And I think it's possible now that the book is out. And I'm
[1:23:49] kind of saying no to a lot of things. Yeah, you have to do at
[1:23:54] some point. I'm fortunate that I'm in this position where I can
[1:23:58] actually choose what I'm going to work on and what I'm doing
[1:24:03] and not doing. So I know. I'm very blessed. I know that not
[1:24:05] everybody has this luxury. I also think I earned it. Honors.
[1:24:10] Dr. Mindy Pelz: Yes. Yes, you did. Yes, you did. So
[1:24:15] Lisa Mosconi: thank you so much. I think we've done three if
[1:24:18] you've joined me how many? Three? This is my third. Yeah,
[1:24:21] Third time's the charm. Yeah, it I think getting back into having
[1:24:26] a regular exercise routine. I love working out. I love it. And
[1:24:31] sometimes I just can't find that kind of window time that I can
[1:24:37] actually relax and just work. I'm usually just like, Okay, I
[1:24:40] have 20 minutes. What can I do in 20 minutes. And now I'm like
[1:24:43] right now, I'm going to have time. I don't work. I don't want
[1:24:47] to work on weekends. If I can avoid it. I want to spend time
[1:24:51] with my family and I've been meditating for a really long
[1:24:54] time. So that really helps me. As we talked about, I don't eat
[1:24:58] at night. It's a kind fasting, ate super healthily, in general.
[1:25:03] That's a good foundation and sleep. Yeah.
[1:25:07] Dr. Mindy Pelz: Yeah, get it while you can. Yes. Yeah. Yeah.
[1:25:11] Well, Lisa, this was amazing. How do people find where do we
[1:25:14] send people for your book? Yes. If the typical spots.
[1:25:18] Lisa Mosconi: Yes, typical sports. I have a website. I'm
[1:25:20] going to have a ball. It's at Lisa Mosconi that calm and then
[1:25:24] on Instagram is probably the best way. I'm more active on
[1:25:29] Instagram. You're on Yeah, I'm scary. It's scary for me social
[1:25:33] media is the Wild West
[1:25:36] Dr. Mindy Pelz: it's a lot It is scary. You have to you are
[1:25:39] putting yourself out for constant interpretation. So
[1:25:43] yeah,
[1:25:44] Lisa Mosconi: even never occurred to me to be rude to
[1:25:46] another person. Maybe online or otherwise. It's just occurred to
[1:25:50] me. No, I agree. And very strange. Yeah.
[1:25:55] Dr. Mindy Pelz: Well, this is amazing. I we're gonna keep this
[1:25:57] conversation going someday, I hope to meet you and just thank
[1:26:02] you for this. This was was it this was like so thirst
[1:26:07] quenching to my mind. And I just appreciate all the work you're
[1:26:11] doing. And we just have to keep helping women see the
[1:26:14] information that all of us are bringing, and so that there's
[1:26:18] hope, there really needs to be hope. So. Thank you for all you
[1:26:22] do. Thank you. Thank you so much for joining me in today's
[1:26:30] episode. I love bringing thoughtful discussions about all
[1:26:33] things health to you. If you enjoyed it, we'd love to know
[1:26:37] about it. So please leave us a review, share it with your
[1:26:40] friends and let me know what your biggest takeaway is.

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