The Midlife Feast
The Midlife Feast
#162 - Rewiring, Not Retiring: How Your Brain Transforms in Menopause with Dr. Sarah McKay
Ever walk into a room and instantly forget why you’re there? Or struggle to find words you know are on the tip of your tongue? I have good news for you! You’re not losing your mind. Your brain is simply changing.
In this episode, neuroscientist Dr. Sarah McKay reveals what’s really behind midlife “brain fog” and why it’s part of a powerful transformation. From hot flashes and sleep struggles to surprising cognitive strengths we gain in menopause, she shares what’s happening inside the brain, as well as how to support it through the transition.
You’ll walk away with science-backed strategies, a fresh perspective on midlife cognition, and maybe even a laugh or two (yes, we talk creatine and the importance of laughing at ourselves in this season). This is a conversation that will leave you feeling reassured, informed, and ready to support and embrace your evolving brain.
Connect with Dr. Sarah McKay
Grab the Brain Health Books
Instagram: @drsarahmckay
Website: www.drsarahmckay.com
Like what you learned? Check out these other episodes!
- Beating the Brain Fog of Menopause
- 5 Things My Sister Wants You to Know About Perimenopause
- When Mental Health Meets Menopause with Dr. Stephanie Bayliss ND
- Why Healthcare Needs to Break Up with Diet & Wellness Culture with Dr. Sylvi Martin
What did you think of this episode? Click here and let me know!
📚 I wrote a book! Eat To Thrive During Menopause will be out on October 21st, 2025. Pre-order your copy today and help get the word out!
Looking for more about midlife, menopause nutrition, and intuitive eating? Click here to grab one of my free guides and learn what I've got "on the menu" including my 1:1 and group programs. https://www.menopausenutritionist.ca/links
Okay, let's be honest. Hands up for anyone who has Googled. Am I losing my mind when you have forgotten the name of the person that you have known your entire life, or somebody that you see every day? Or when you've walked around the house for two hours looking for your glasses that are on your head, or when you struggle just to find the words that you know are there? I know that when I was in the thick of perimenopause, especially in late perimenopause, when my periods were many, many months in between, I really worried about what was happening in my brain. You know, when I struggled to remember somebody's name and it was on the tip of my tongue and I just couldn't spit it out, or when I couldn't find the word, or when I froze in a sentence or forgot what I was saying as I was saying it, I couldn't help but worry or wonder what is happening. And like most of us, I think, who are in midlife, we're aware that brain health is something that we probably should keep an eye on or know about. Or maybe our lives have been touched by somebody who has Alzheimer's or another condition related to that cognitive decline and we're worried about it. And there's so much noise as there is with many things menopause, but especially with brain health and hormones, and what do we need to do about brain fog? And that is why I am so, so excited to bring this conversation to you with Dr Sarah Mackay, who is an Australian neuroscientist. She has written many books. Probably the one that I read and that you know I think is most relevant to those of us in midlife, which is the Women's Brain Book the Neuroscience of Health, hormones and Happiness. But I really love her, not only common sense and reassuring, without, you know, placating, but just explaining to us what is happening to our brains in what I think is actually an empowering way. So have a listen to this, regardless if you're in perimenopause, postmenopause, in the thick of it, if you can't even remember why you're sitting in the room that you're sitting in, I promise that you will learn something.
Jenn Salib Huber :And this episode is a little longer than usual because we had so much to talk about. Longer than usual because we had so much to talk about. And I asked her one question which I really it surprised me. But I asked her about creatine, which, if you're in menopause, you've heard about creatine, and I can guarantee that her answer will surprise you so much. So thanks to Dr McKay and, as always, let me know if you have any questions about this episode. Dr Mackay, and, as always, let me know if you have any questions about this episode. Welcome, dr Mackay, to the Midlife Feast. Thank you very much for having me. So before we dive into the topic of the brain, which is a very, very popular hot topic in all things midlife and menopause, please introduce yourself to the audience please introduce yourself to the audience.
Dr. Sarah McKay:Yeah, sure, so I am Sarah Mackay. I am a neuroscientist. I'm sitting looking. Well, I was looking earlier out across the northern beaches of Sydney, australia, but it's getting a bit darker now, so you know I can't see as much as I could. I grew up in New Zealand, christchurch, new Zealand. Lots of people when they hear my accent aren't quite sure where it comes from. I suppose it's perhaps a bit of a hybrid, but I'm also married to an Irishman, so there's a bit of a mix in there.
Dr. Sarah McKay:I did neuroscience as my undergraduate of psychology lecture in 1993. And I switched universities the next year to pursue a degree in neuroscience and it's really kind of been the path I've followed ever since. I did my master's and a PhD at Oxford University I was very grateful to the funding from the Wellcome Trust for that and then I did a couple of postdocs over here in Australia, but then bravely anyone who's been in academia knows how hard it is to leave decided to hang up my lab coat and I set up a business in science running a kind of a science writing, education, communications business specialising in neuroscience. And then the last sort of 10 years now I've had a real interest in women's health through the lens of neurobiology, health through the lens of neurobiology. Before then I had never really considered neurobiology through the lens of the female lifespan, just because there's so much to think about when it comes to brain health and neuroscience and there's a lot of cool topics within that that I was busy thinking about.
Dr. Sarah McKay:But I was asked to write for the ABC here in Australia an article on menopause and brain fog and that really kind of shifted my trajectory, because I was then asked to write a book and I decided that that would be a book about women's health across the lifespan. And so I've been very, very closely following for the last 10 years this particular little. What was once a niche women's health and neuroscience once a niche. They no longer are, and that's sort of how I how I found myself here on your podcast. I speak, and I've written a number of books and do social media and and I found you through social media.
Jenn Salib Huber :I think how that's how most of us find people, rightly or wrongly, these days, and I mean, there's no question that you're an expert, and that's why I'm so honored that you took the time to be able to come and speak to us today, because I think that so much of the messaging that we see on social media is trying to scare us about what's happening to our brain, and there's one particular reel that you shared a couple of months ago that was really talking about how our brain is just making these new connections, and it really it was reassuring, but it was also a bit inspiring.
Dr. Sarah McKay:Oh, was it the one about midlife brain? Yeah, how it goes from being segregated to integrated.
Jenn Salib Huber :Yes, and I thought this is perfect, and I think that was when I reached out and I said would you please come talk to me? So why don't we back up a little bit and say what happens to our brain as we go through this transition, which is normal, right, but what is happening as we go from our peak reproductive years, when we're swimming in regular amounts of estrogen, or estrogen and progesterone and all of the other hormones and then we start to go through this transition where we're starting to run out of eggs and hormones are on a bit of a roller coaster?
Dr. Sarah McKay:Well, we still don't know that much, to be perfectly honest, about exactly what is happening, and that's because we still need some really good studies to be done, the kind of the gold standard, the sort of studies I would like to see that would help us understand this kind of transition a little clearer would be a longitudinal study where we'd have you know me and you know ideally 100,000. That would be great but probably 1,000 other women and follow us from, say, our late 30s through until our early 60s and look and study every aspect of our brains, sort of every year all the way through that transition and have a look at levels of our hormones. What are our periods like? Let's do brain imaging studies. Let's look at the structure of the brain. Let's look at functional type of brain scans where we're looking to see how networks respond and connect and react as we go through this transition. Let's do a whole host of different types of cognitive studies and look at women's mood and look at women's cognition and look at our emotions and look at attention span, look at memory et cetera. Just like let's just measure it all and do it in many, many women and kind of follow them through. And we haven't got those kinds of studies out yet and that would be really the gold standard to describe what is happening across this point in time.
Dr. Sarah McKay:There are a number of reasons why those studies haven't been done. They have been done for other points in the lifespan, for example during puberty and across the course of a first pregnancy. Pregnancy is a good one because it's sort of nine months. So you know you get a whole group of women and scan them and do all of these kinds of tests and studies on them and then follow them across the pregnancy and look at them afterwards and you wouldn't have it done in a year because you can't guarantee if you've done all of the scans before someone tries to get pregnant she will.
Dr. Sarah McKay:But menopause from having a completely healthy, regular cycle through to flat lined out the other side that could be 10 years, that could be 15 years, it might be much shorter in other women. So that's a harder study to do. So we're kind of scraping together lots of different types of studies and a lot of the time making assumptions from animal studies that have been done and a lot of observational studies and a lot of cohort studies. So these might be looking at a group of women you know, who are still fertile and regularly cycling, a group of women in perimenopause, a group of women afterwards and looking at differences between those groups of women. We haven't got the kind of the full gamut yet. So a lot of what I say is based on less complete science than I would certainly like and I think a lot of others would certainly like.
Jenn Salib Huber :So I guess maybe the better question is what do we think?
Dr. Sarah McKay:we know.
Dr. Sarah McKay:What do we think? We know, well, so when we think about a brain, there's a lot of things that we can consider. We could measure, we could get metrics on so we could look at, you know, just like the overall size. I've got a brain lying around, not a real one, a plastic one. You know, just like the overall size. I've got a brain lying around, not a real one, a plastic one. You know you could just like look at the overall sort of size and shape of a brain, right, you could measure its whole volume. Or you could, you know, zoom in on one particular part and take a slice through and look to see how thick is the grey matter or what's the volume of this particular structure. Or you know how wrinkly is it. You know, we can just look at, like the structure. Or we could put it in an fMRI scanner, which is a functional MRI, which kind of takes a video of that brain in action. So you know we could do that.
Dr. Sarah McKay:As I said, there's, like there's so many different types of measures that we can make that we need to sort of. You know, I have to sort of start somewhere with my explanation, right? So let's start with what we know for sure is going on in terms of the brain ovarian axis, like that brain ovarian function. Because that's the starting point and the point in which we've got the best, this, the best sort of understanding and data, and then perhaps we can zoom out and say this is what we think happens to its structure, this is what we think happens to its function, this is what we think happens to how it works. So is what we think happens to its function. This is what we think happens to how it works. So you'll be familiar with I mean, we all should know, like, if we've got menopause, we know what our HPO axis is, even if we don't call it that.
Dr. Sarah McKay:That's our hypothalamic, pituitary ovarian axis and that has this regular monthly conversation going on between your brain and the ovaries which kind of regulates your menstrual cycle, starts at puberty. Perhaps you regularly cycled your whole life, perhaps you were on the pill for decades, perhaps you had lots of pregnancies, but then you kind of get to the end. We know, in those kind of perimenopausal years, as they're called, that is when that conversation starts to change between brain and ovaries. Now puberty is turned on by the brain, but menopause is different. That conversation is turned off by the ovaries because basically your eggs start getting too old and your ovaries don't respond to signals from the brain in the way that they used to. So some months they might try really, really, really, really hard to ovulate and they might produce a whole lot of estrogen and your brain's going well, that was very loud and it says to the ovaries not that much. And the ovaries go okay, and so the next month they just sit there and they don't do anything. So you might skip a cycle, you might have no estrogen the next month. You know, the brain's kind of shouting, shouting, shouting, sending more signals down to the ovaries. The ovaries release a lot and that could happen for a few months or a few years.
Dr. Sarah McKay:You get this very erratic rollercoastering of hormones which are a result of this kind of disjointed conversation between the brain, the hypothalamus and the pituitary, I mean the ovaries, the hypothalamus and the pituitary. Once that kind of conversation stops and dies, that's when we say well, you've got menopause, you're not cycling anymore, everything flatlines. The result of both the rollercoastering and then the flatlining of those ovarian hormones has a whole heap of direct effects, but a whole heap of knock-on effects throughout our body and brain which we would then. You know, some women sail through that whole you know sort of phase of life and don't notice a thing and kind of carry on as they did, just like how someone sailed through pregnancy and think it's great and don't notice anything or never have any problems with you know their periods. Other women are just like flattened by it, and then lots of women are kind of in the middle. Perhaps about half of women are in the middle, just have some symptoms and maybe they are more or less bad each month or year as time goes on.
Dr. Sarah McKay:So I suppose the key then is to go well, what's happening to the brain in response to first the fluctuations of hormones during perimenopause and then the flatline afterwards.
Dr. Sarah McKay:I feel like I'm being kind of quite wordy and belaboring this point, but there's so many different aspects that we could be kind of looking at here, and I don't want to jump straight to symptoms, because I don't want to jump straight to when your ovaries start to kind of have that conversation failing with the brain, that our brain fails and everything goes wrong and all we become is this kind of catastrophic bundle of symptoms and we've just become this sort of midlife kind of disaster, which is the conversation that drives me crazy, because I just don't really think it's this.
Dr. Sarah McKay:I mean, I think it's descriptive of someone's experiences, but not the only experience for every woman. So the one thing that we understand the most in terms of symptoms that women experience that are to do with the brain and are to do with these changes in ovarian hormones are vasomotor symptoms or hot flashes, and that is perhaps the most. That is perhaps the sort of symptom that we really understand the neurobiology of the most. Everything else is just kind of conjecture, believe it or not, despite what you may hear on social media.
Dr. Sarah McKay:Really, yeah, crazy, right. So essentially, what happens in your hypothalamus? This is a very busy part of your brain. It's kind of right down, it's like below hypo, below your thalamus. It's in constant communication with your pituitary gland which releases hormones, because that's what glands do into your bloodstream and it is getting all of this data from your body about everything to do with hormone levels, as we've just talked about, but body temperature and your heart rate, and you know your blood pressure and you know what time of the day or night it is. You know there's a whole lot of information kind of coming in, giving you know.
Dr. Sarah McKay:It's kind of collecting all these metrics about your body's information and one of those metrics, as I said, is body temperature and interestingly, for some reason that we don't know, but evolution has decided, or mother nature, as I like to say, has decided it was a good idea that this thermostat that we have in our hypothalamus, which helps regulate our body temperature, is set in part by levels of estrogen or by estrogen once you've gone through puberty. Before that I haven't actually looked into the science as to what happens with thermoregulation before puberty. I'll put that on my list to do, essentially when the ovarian hormones start to fluctuate. The thermostat kind of gets narrower, so the top level goes down, the bottom level goes up. So you've got a much narrower sort of set level in which your body temperature can fluctuate before your hypothalamus perceives you as being either too hot or too cold, and lots of people get extra sensitive to cold as well.
Dr. Sarah McKay:We don't talk about that as much or it doesn't seem to be as common. So what happens is when your body temperature rises slightly and it hits that kind of top level which is dropped down due to lack of estrogen, your hypothalamus then sends two types of signals out to your body to cool you down and they're quite panicky because it's like you've really hit that kind of top level and it's almost kind of like panic stations cool down now. And there's two ways it can do that physiologically and that's by flushing, by dilating all your blood vessels so you're dissipating heat out of your body, and by sweating, which is helping to dissipate that heat out of your body. So that's that physiological response and it kind of try and it sends that signal all throughout kind of your body. It's not just like the blood vessels in your face, it's all the way down your legs, it's everywhere. So it's sending this kind of this sort of signal through your sympathetic nervous system, which is this kind of like direct wiring from your brain to your body to tell your blood vessels to dilate and your sweat glands to sweat. But it also then gets you to behave in a behavioral way because you feel hot and then you've learned for a lifetime that when you're too hot, you take your jumper off or if you're asleep, you throw the covers off lifetime that when you're too hot, you take your jumper off or if you're asleep, you throw the covers off.
Dr. Sarah McKay:The problem, the big problem here that our brain has is when we are asleep, because it can do a really good job of calling us down.
Dr. Sarah McKay:When we're awake, because we're awake and we behave in ways to call ourselves down.
Dr. Sarah McKay:So many problems, I believe, or so many symptoms of perimenopause and menopause, come about as a result of what is happening when we are asleep and our brain is trying to cool us down because we are asleep, and so we're not behaving in a way to cool us down, and often we're covered up with a duvet, we're covered up with blankets, and so our brain's trying its best to cool us down under those blankets and it can't, and so then it needs to wake us up, and sometimes you consciously wake up with night sweats or a hot flash and you throw the covers off and then you cool down and then you get cold and then you put them back on, and it's this kind of cycle or you might wake up, or you might be quite deeply asleep and your brain really starts to panic and tries to wake you up very, very urgently, and so it sends another kind of signal through your sympathetic nervous system.
Dr. Sarah McKay:It's almost like this shot of adrenaline is then released from your adrenal glands and your kidneys so you might wake up with a start, and lots and lots of women will sort of describe that, that kind of feeling like they've gone from deep sleep to suddenly waking and it's almost you can feel adrenaline kind of coursing through your body.
Dr. Sarah McKay:It's almost as if you've been given a fright and your heart kind of races and then you've got to like I'm laughing and then you have to like calm down, because exactly, that is exactly what you, and you feel it in your muscles in the same way as if you've been given a fright, and the adrenaline goes in your muscles and you know like you can get shaky legs, like that feeling like when you've been given a real fright. But that's happening when you're lying in bed asleep and so your body thinks that you've been given a big fright and you wake up just because your poor little brain is trying so hard to cool you down, even though you weren't actually necessarily that hot. If 20 years ago it wouldn't have woken you up right Because your thermostat wouldn't have been disrupted, so it's like our main short circuits, the hypothalamus short circuits.
Dr. Sarah McKay:Yeah, it's trying its very best to cool us down because it believes we are extra, extra hot and there are a number of knock-on effects of this. So we know you vary, but let's say, half to three quarters of those hot flashes wake us up. We may not necessarily consciously remember it the next day, depending on what kind of sleeper we are. I'm a pretty good deep sleeper, so you may or may not remember waking up. You might go straight back to sleep, or you may be someone who has never really slept very soundly or has disrupted sleep and then you can't get back to sleep. Or what happens is you might not necessarily wake up, but your sleep architecture so that you know you kind of cycle through these levels of sleep through the night, through deeper sleep and lighter sleep that architecture is quite an important. You know it's important for your brain to cycle through those different levels of sleep, to kind of also do all of the other things that the brain does like, remember what you've done through the day and flush out all of the kind of the, the molecules that have built up, you know, through through metabolism during the day, just to do all the things that brains need to do when there is sleep and when that architect is disrupted, that disrupts that kind of natural sleep, even if you don't consciously remember waking up. So what's kind of the knock-on of that? And there's one thing here which I'll talk about, which no one ever talks about because I don't think many people are thinking about it. One is just being woken up multiple times a night for days or weeks or months or years. We all know what it was like if we had babies. We all know what it's like now. If you're going through menopause and you haven't got that sort of sorted Short story is if you put estrogen back in, we know that that really helps. It doesn't completely obliterate all of these symptoms, but it can help very much so with the thermoregulation and it might help with the disrupted sleep if the disrupted sleep is a direct result of the thermoregulation problems. But the inevitable consequences of disrupted sleep over time are just problems with your cognition.
Dr. Sarah McKay:Let's say that we could call it brain fog, which is a very, very, very commonly reported symptom. But I really don't like the word brain fog because it's a colloquial description for symptoms that women experience, but also other people use that phrase. You know someone with a head injury perhaps, perhaps, or someone with ADHD perhaps, or someone who's had chemotherapy for cancer, or someone who's recovering from long COVID, or you know. You just haven't slept for a few weeks because you've got insomnia. You have problems with many aspects of how you feel, your brain is working and I think that we need to do a better job of coming up with better, clearer terms for brain fog than what we've got so we can describe it and study it and understand it. Let's just say we've got brain fog, but then we've also got kind of hand in hand with that and again hard to untangle from the cognitive symptoms maybe, the inability to regulate your emotions as well as you may like.
Dr. Sarah McKay:Now, some people might call that feeling depressed, some people might call that feeling irritable or angry, some people might just feel moody and out of sorts. There's lots of, again, different words that we would use and again, I think we need more language here to describe just that kind of emotionally dysregulated. So we've got these kind of cognitive and then emotional symptoms which come about through disrupted sleep. The problem that we're trying to untangle and there's researchers working on this is untangling the brain fog from the sleep, from the hormones, the mood or the emotional instability from the brain, fog from the sleep, from the hormones, the mood or the emotional instability from the brain, fog from the sleep from the hormones. Are there direct lines or is this just this kind of tangled web of feedback loops? It's probably going to be a tangled web of feedback loops, because that's kind of how the brain and the body work, of how the brain and the body work. Yeah.
Jenn Salib Huber :And I mean anybody who has experienced sleep deprivation for any reason you know whether you're 15 or 55, will know, will have that lived experience of how hard it is to feel like your brain is firing on all cylinders.
Dr. Sarah McKay:Yeah, and it's just yeah. And there's so many, and that's the thing you were saying. Brain isn't firing on all cylinders and there's so many different types of, again, ways we can measure and describe brain fog and the different types of experiences that different women have that they might colloquially call brain fog, but all could be quite different. You know, just kind of remembering what they were planning to do each day. Or they walk into a room you don't know why they're there. Other people have perhaps specific and the most commonly that we can pick up. If we do tests, you know, cognitive tests, we can't always pick up any cognitive changes, but when we do, often we pick up the verbal, the word learning or the word memory, the verbal memory changes, which might be things like remembering people's names. Or you just might pull a complete blank when you're trying to remember someone's name. Or you know that movie about that woman and she's married to that guy and you know he's the doctor. You know, and you can't remember it. Everyone's been there, everyone's been there.
Dr. Sarah McKay:Or my particular specialty is more of a sort of a semantic switching whereby I and I and I go through phases of doing this whereby I'll say a word that's related, but it's different. So my son walked in the other day and he had a hat on. I said, oh, you've got it on a nice warm lid, I mean. And then I was. I was out with friends recently. I stayed with friends, I was on holiday and me and my friend we were going to go to a cafe for breakfast and I said to her husband are you going to come to the pub with us? And he was a bit early for that. I said I meant cafe, not pub, I don't know why. So I do that. That's my specialty. It's just like pub, similar, but I switch them. So would I call that brain fog? I wouldn't call that brain fog, but there's definitely a glitch.
Dr. Sarah McKay:Other people might have trouble with attention. There's lots of different types of cognitive changes that we perceive and I think that it's really interesting because some might happen as part of a constellation of other types of symptoms like lack of sleep and mood, and whereas others some women might have no other symptom and I would possibly put myself in this bucket that my, mine is just that weird word switching, mind you. I was walking along the road with a male friend the other day. He's 52, he is under a whole lot of stress at the moment.
Dr. Sarah McKay:And we're walking along by a river and there was a mattress Some kids probably have thrown a mattress in the river and he said oh look, there's a mushroom in the river. He says I made a mattress. And then I just laughed because as soon as he said there's a mushroom in the river, I knew exactly what, because it kind of looked the color of a mushroom, I don't know. So I think we tend to, we all have these glitches, but sometimes we hone in on them and then I wonder if somehow we're putting them under the same umbrella of brain fog, whatever that means, and I would love to unpack that.
Jenn Salib Huber :Yeah, and I mean I love that. I love that we're trying to define it. I love that we're trying to define it and it's really interesting because I also didn't like the word brain fog, because it felt too I don't know ambiguous, and yet when I went through it it actually did feel like an accurate description of the experience. You know, because I am some, I'm a type. I always say I'm a type A person.
Jenn Salib Huber :I was diagnosed with ADHD at 19. I'm the kind of person my feet hit the floor, I go like I'm high energy, all that kind of stuff, and perimenopause hit, and I was. You know, I was fully menopausal by 44. So I'm in that kind of transitional early group and all of a sudden I couldn't cope. So the things that I was a rock star with give me a list of 10 things to do all at once. I'm on it. That's like my favorite thing.
Jenn Salib Huber :I would freeze, I would panic, my brain would just completely short circuit or I would not be able to handle just everyday stressors. If I had three things to do in the morning, I would worry about it the day before and these would just be like three normal things, and so it always felt like I was searching for something, but very much to what you speak about on social media and what I've heard other experts in the field talk about, it got better. I'm now three and a half years post -menopausal. My mental mojo has been firmly back in its seat now for at least a year, and you know it's really and yes, of course I'm not as fast as I was 30 years ago with that cognitive recall.
Dr. Sarah McKay:But none of us are. We just valorize that as the type of brain function that we think is the best. We forget about all of the other things that brains do and become more capable of. As we get older, you know, we become more flexible in our thinking. That kind of peaks around midlife. You know, we've gained so much wisdom and knowledge and experience and we might not be as quick, but we're often more careful and more thoughtful and can think more deeply because we're drawing from greater reserves of experience. So we tend to focus in on those skills which peak perhaps in our 20s, as being the only ones that matter, because we perhaps will have always relied so heavily on them and I think, the more you rely.
Dr. Sarah McKay:Interestingly, I spoke to two different researchers and they both said the same thing that it was women who were lawyers who noticed the verbal issues more, more than other professions, because they rely so much on like verbal gymnastics and if words are like your tool, that was what they noticed. So we could study them and we could throw a bunch of cognitive tests at these lawyers and we probably wouldn't pick anything up. We wouldn't be like going well, yes, well, you're in the early stages of dementia, because this is an entirely different phenomena. But those women are feeling those little tiny losses because they're really peak. They're peak performers, you know. They're probably not like worrying about how fast they're doing the 100 meter sprint, um, you know, or?
Jenn Salib Huber :you know that's not quite as good at the vault. Let's talk about the difference between the normal subjective cognitive impairment of perimenopause and menopause on this brain versus dementia, because of course that is the concern that when we start to forget things, when we can't remember names, that it's a, it's the canary in the coal mine, and you know. So what? What does the research tell us about that relationship?
Dr. Sarah McKay:yeah, so they are not necessarily related at all and I think it's one of the most common concerns because brain fog is definitely one of the most common concerns that women have and it feels like when you're reaching midlife, you probably have a family member or someone that you know or someone that you know's parents have experienced dementia or Alzheimer's disease. Some type of you know dementia is the umbrella word for collection of symptoms, and Alzheimer's disease is one of the main causes of that, and no one wants to go down that path and we're pretty familiar with the idea that forgetfulness is one of the symptoms of dementia, but it's certainly not the only one and it is extremely, extraordinarily rare. Before the age of 65 and even really, you know, before the sort of 70s, 80s, 90s is really when we see the incidence start to uptick. So it was very, very rare, even if you have a genetic predisposition, to be experiencing it in your 50s. You would probably be likely to have other family members that have started to experience that very young, but it's a completely understandable, it's almost a rational concern, right?
Dr. Sarah McKay:However, if a woman is going through perimenopause and her cycles are starting to become very, very irregular and she's got other types of symptoms, or maybe this is the only one, then it's probably more likely to be a consequence of perimenopause and whether it's directly due to the hormones or a knock-on effect of other issues, that's probably likely to be the situation. Not every woman experiences this. So if we looked at you know a thousand women transitioning through, you know some of them won't. You know we won't be picking anything up at all. Some of them won't notice a thing, others will find it, you know, something reasonably significant that they are struggling with. And, exactly like you said, what we often see in most women, but not all women, is we start to see those sort of symptoms improve and what we're seeing, or what we think we're seeing, we don't really know yet.
Dr. Sarah McKay:But certainly my informed opinion would be that the brain retains its plasticity and it adapts and responds. And it's adapting and responding to lots of different hormonal situations throughout your lifespan, from puberty, through each cycle, through pregnancy, this enormous hormonal shift, postpartum breastfeeding, and then it will also react and respond to menopause. And we've lived for many, many years beyond the menopause for a long time and our brains have evolved to adapt and respond and kind of settle into this new normal, so to speak post that time. It just sometimes takes a while for things to reorganize and respond and then settle down, so to speak. And we see and I'll talk a little bit about the study I talked about that you saw on that reel I was speaking about as brains kind of go through childhood and hit puberty and they go through adolescence and those pubertal years. We see that that's when a lot of functions in the brain jobs that different parts of the brain do start to become kind of more refined and defined. And if we were to image the brain doing different types of jobs, we would see as it gets better at doing those jobs. The parts of the brain involved with those jobs would almost get more selective and specific. There would be connections and communications between different brain networks but they would almost be quite segregated. It's almost as if they've all taken on a new role and they're refining and getting better at that role. They'll still be communicating with each other but the sort of departmental roles will be set. But then when we go through menopause we see this. When women are going through menopause this process speeds up a bit.
Dr. Sarah McKay:But also as men get older as well, we start to see if we're looking at brain networks, we see a little less segregation and more integration. We see this in the hippocampus, in women going through menopause, and the hippocampus is involved with things like spatial orientation and memory and turning short term memories into long term memories. We might see one heart, one side of the hippocampus, taking on a lot of the memory roles or learning you know, learning new words and then after menopause we might see both sides becoming active at the same time. So it's almost as if what we see as we're aging we see less segregation and more integration. It's almost as if the brain kind of knows that it might need a little bit more of a hand.
Dr. Sarah McKay:Perhaps each part of the brain or the neurons in each part of the brain aren't quite functioning quite as fast or as efficiently as they used to. So it's like let's kind of work together guys, let's kind of cooperate a bit more and let's recruit a few more departments in or some more helping hands, and we see more integration. So the job can still get done, but the brain starts to. You know, different parts of the brain will coordinate to get those jobs done in different ways as we age. I think that's great, and perhaps you know that reorganization and as those networks are starting to desegregate and become more integrated. You know, maybe that's why, when we, as that process is taking place, maybe that's when we sort of start to see, you know, the forgetfulness or the fogginess or the switching of words like I do. That may be part of it. We don't actually know whether that's the case, but that may be part of it and that makes sense. It's kind of cool to think about.
Jenn Salib Huber :Yeah, it is kind of cool and I really like the visual of the integration because it's like you know, we do gain perspective and we've taught we always hear about how you know, you gain wisdom with age and perspective and you see things differently, and that really is true. And you know, when I think of how many women start businesses, write books, so my cookbook that comes out in the fall. I started writing that a month and a half or so after my 12-month anniversary and I really don't like of not having periods. So once I entered post-menopause I really was like okay, I actually want to move through with this dream of mine, and I know that I didn't have the capacity for that before, but all of a, as that rewiring was how was happening. Now that I know that, that it's a rewiring the parts that had been working separately.
Dr. Sarah McKay:Just all of a sudden we're like, hey, we can work together we can do this, yeah, and I think it's um, and we, we see so many strengths emerge at this time and it just drives me a little bit crazy because we're only focusing on the deficits and I understand that we're having to start to talk about this because it hasn't been discussed, but we're focusing on it as a medical catastrophe sometimes, and for some women it might feel like that but we're not also talking about the strengths and the upsides and what's peaking at this time in our lives and the trajectory which we could potentially choose to be going down, if we can see the upsides of some of these changes, instead of talking only about symptoms and treating symptoms. We're not talking also about the strengths of a midlife brain and the types of cognitive changes that we see. And, you know, perhaps maybe there's some evolutionary adaptive benefit to all of this because our fertility declines. You know, perhaps our bodies are just no longer capable of nurturing new life and that's why we, you know, go through this kind of reproductive senescence, because our bodies just aren't capable of nurturing a baby. We're capable of looking after other people or doing something different instead, and maybe our brains are adapting and adjusting and responding to not so much being a mother or a parent or a bringer of life, but we're kind of taking on some more matriarchal role and we need a different type of brain processing to do that, to be kind of a matriarchal leader, a font of wisdom. I don't know whatever kind of analogies or metaphors we can think of here, but perhaps our brains are actively adapting towards that, instead of we're thinking about what we're losing, not what we're gaining, because we aren't at the point where we're necessarily having the conversations about what are the upsides of having an older brain, because we only talk about what we've lost, where our cognitive test scores have dropped, and that's a real shame. But I understand, you know that'll balance out in time. I'm still going to be here in 10 years' time and you know who knows where that conversation will be.
Dr. Sarah McKay:There's one other thing I didn't talk about and I just want to bring up because I think that this will help lots of women as well understand what may be going on is when I was talking about our poor little brains trying to wake us up at night, and to do that they've got to kind of send some adrenaline through our body to kind of wake us up, and we understand very well what happens to our brains and our cardiovascular system and our bodies when this happens with sleep apnea, so when someone falls asleep and then they have to wake up to become slightly conscious enough to be able to breathe, and so that continual sympathetic activation puts quite a strain on people with sleep apnea's heart, their cardiovascular system. We know their overall health and we've got quite clear kind of metabolic, cardiovascular, overall health outcomes established in that kind of space less so, I believe, in the menopause space. But what we are seeing is this kind of switch more towards sympathetic activation and away from as much balance with parasympathy activation and I don't again there's all these words I don't like using, but people may have heard of the sympathetic versus parasympathetic balance about being fight or flight and rest and digest. Let's just say that the sympathetic nervous system at its absolute extreme of being dialed up is fight or flight, but it also is responsible for raising your heart rate before you stand up so you don't faint. It's essentially allowing your body to adapt and respond and then your parasympathetic is bringing you back down. It's not only enabling you to run away because you think you're about to die, because the tiger's going to eat you. Okay, it's responsible.
Dr. Sarah McKay:Across each breath we take is this sympathetic, parasympathetic kind of you know, seesaw. But we know when women go through perimenopause and menopause they become more sort of there's a bit more of a sympathetic kind of activation and less of a parasympathetic activation. And if you are continually activating your parasympathetic nervous system enough that you're going from deep sleep to wake, to wake you up, to cool you down, you become what we might even call hypervigilant. You become like wired and tired, and sometimes some of the first symptoms that women notice is not so much mood but is anxiety and anxiety is a word again that we use that our brain is trying to make meaning of. Why is my nervous system kind of wired and why am I feeling hypervigilant and edgy? There must be something that has happened that I need to worry about. And if you're a mother, well, I've got two teenage boys.
Dr. Sarah McKay:There's plenty of things that I can just decide to worry about, because my nervous system is a bit edgy, because it's got more of a sympathetic kind of bent. It's waking me up, I'm tired, and so our brains respond by trying to fill in the gap, by trying to make meaning Well, there must be something out there that I need to be concerned about. And so then we start worrying about something, and then we can ruminate, and so that can often be some of the very first symptoms that women experience as well, and so that can often be some of the very first symptoms that women experience as well. And again it's kind of gone back to just our brain sort of trying to make the best of a situation it's found itself in. Yeah, and then we've got this physiological nervous system response and again then the mind's going well, I need to kind of there must be something kind of going on. Let me just fill in the gap by worrying about a thing, and I worry about this thing and that thing and the other thing, and then that's kind of what anxiety is, and so when we're trying to then manage anxiety, we often think, oh well, I've got to change my mindset.
Dr. Sarah McKay:But also our sympathetic nervous system is perhaps slightly more activated than it has been, and so we've got to find kind of ways to dial that down. And that's hard to do if it's constantly being activated all the time to kind of cool you down. So you know, again, there's kind of sparsity of research in this particular space, but I think it's really important. Autonomic regulation is something that we need to be studying and thinking about. Can we kind of help help? You know, if we put the estrogen this is me putting estrogen back in, if you know we rubbing it on or sticking our patch on or whatever we do, um is is this going to help with that sympathetic rebalance? Um, and is that going to help dial down anxiety? But at least you know there's a feasible physiological mechanism to explain some of these feelings that we have, and our brain is pretty powerful. It's going to fill in the gaps. That's gonna there's. There's something out there that's going wrong. I'm gonna like your brain will find something to worry about and it won't leave it hanging.
Jenn Salib Huber :Like you know, this is what I often talk about with the thoughts that we have. Like if your brain has a thought and it cannot explain why, it will connect dots. So sometimes, you know, with anxiety at least, you're worrying about things that are really more of a perceived threat than an actual threat, because your brain just needs a reason, right?
Dr. Sarah McKay:Your brain needs a reason for why you're feeling anxious. So these? So in this instance, it's almost like your body is responding as if something is about to happen, or you've just woken up with a fright, and so your brain's going at 3 am, you know, it's my teenager home, yet let me look at this. You know, oh, I've had a car, whatever. You start catastrophizing, um.
Dr. Sarah McKay:So I yeah, so I just wanted to fill that gap in as well, because I think it's a really under discussed aspect of kind of neuroscience um and and menopause absolutely and I love the connection to especially our nervous system connection because I think, especially when we experience what we think of as brain symptoms, whether that's anxiety or even sleep changes or whatever it is, it feels like it's something that is happening to us and only our brain.
Jenn Salib Huber :And so we forget that brain body connection yes, and especially that you know, our nervous system starts in our brain, but its purpose is to actually talk to our body, and so that it's in this constant communication with our body and what is happening in the world around us.
Dr. Sarah McKay:And then, because we're humans, we've got this mind aspect right, which kind of emerges from the brain doing what it does, which is so incredibly powerful. And what I'm thinking so much about at the moment in this whole sort of menopause jungle it's kind of gone wild is the messages that we are also receiving. You know we're sitting scrolling on our Instagram the messages that we are receiving about menopause and brain fog and mood and sleep and HRT. Take it, don't you know, you'll get breast cancer, you won't. The women's health study that's all. That's information that our brain is making meaning of as well. Like our brains are making meaning of the and because it's like right in front of our face, our phone, our brain. It's not like in the old days when the TV was on the other side of the room and for like half an hour a night you watched the news and it was just kind of over there somewhere and then you turned it off. Now it's streaming in constantly and the messages and the information that we're taking in our brain is making meaning of too. So we're often and this isn't none of this is to say, anything is in our heads, but if we go looking for symptoms, we might find them. They may not necessarily have been particularly noticeable, but if we're casting around looking for them, oh there they are.
Dr. Sarah McKay:And then as soon as you start focusing in on a particular symptom like you know, an itch, say, so, start talking about your kids having lice or nits, and then you like, think they're down your pants and you start itching. You can make your skin itch, you can make your head itch. You have to like, start itching as soon as you start thinking about itching. Right, that's not because you're a're in menopause, that's because your mind has created, you know, a sensation in your body that you're now honing in on. And this is a very difficult conversation to have.
Dr. Sarah McKay:But our brains and our minds are incredibly powerful in terms of amplifying, but also de-amplifying, signs and symptoms and, and almost sometimes, what we focus in on can we know this? I mean, this is. This isn't even crazy talk. This is like basic, basic neuroscience is why we have cognitive behavioral therapy. This is what placebo and nocebo effects are. This is what chronic pain research has shown us. The more you focus in on a particular sign or symptom, the worse you can make it, and I'm concerned that a lot of the conversations that we are having aren't as thoughtful and careful as they could be in terms of public health, messaging Absolutely and they're amplifying. It's like what you expect when you're expecting menopause. You should expect your brain fog, depression. You know lack of sleep. Your marriage should fall apart. You need, you know, hormone replacement therapy, husband replacement therapy. You know you need to leave your children behind. You know we're starting to expect terrible things and I feel that the conversation is being careful.
Jenn Salib Huber :Absolutely, and I'm so glad you brought that up, and it really parallels something that people will have heard me say about nutrition in this menopause space, and that is you probably don't need more information, more opinions, more facts, you need a filter and you need someone who is qualified to own the filter, and you need to connect with that person.
Jenn Salib Huber :You need to trust and believe in not just what they're saying, but that they have your best interests in mind when they're giving you this information, because in the menopause space we know it's a commodity now A problem and salt isolation. So I'd like to kind of bring it back a little bit to brain fog and what we can tell people who are experiencing this, because brain fog is one of the symptoms, probably right up there with the dreaded meno belly that everybody has a solution for right.
Dr. Sarah McKay:I know how to get rid of meno belly. Don't eat food, but that's not very much fun. If you don't eat, it goes away.
Jenn Salib Huber :It's terrible advice Don't listen to me Right, Right. So you know, when it comes to body changes, I try and reinforce the idea that a human body is a changing body. It is normal for bodies to change. It's normal for brains to change. It's not to say that it's super comfortable and fun as it's happening, but it doesn't mean that there's anything wrong with you.
Dr. Sarah McKay:And we also grew up in the 80s and 90s with all of the messages about being rake thin and it is very, very hard for us to unprogram the decades that the Gen X was taught about the ideal body shape.
Jenn Salib Huber :I have an episode called what the 80s and 90s Taught Us About Diet Culture and it's talking about exactly that. So you know, with brain fog, what I hear from people in my community, you know, and my experience of brain fog, I would say, was average, you know. But you know there's one person who quit her job because she felt like she just could not explain to her boss who you know she felt was not progressive. Let's say, you know that that's what was happening and so it was easier for her to quit. Other people go through really terrible life disrupting symptoms around brain fog and they go searching for answers, understandably. So what? What can we tell them? What does the, what does the research say about, like what helps and what doesn't?
Dr. Sarah McKay:Yeah, it's very confusing the research right now because you would think there should be a case to be made that it appears during perimenopause, when the hormones are kind of going all over the place. So if we just put more hormones in and hormone therapy menopause, hormone MHT, menopause, hormone therapy, whatever you're calling hormone, mht, menopause, hormone therapy, whatever you're calling it, wherever in the world you are, is at this stage still quite a blunt tool, because all we can do is add more estrogen in. We can't do anything except keep putting more and more and more in. We can't recreate that and everything to do with the brain and the body is one giant feedback loop or in a series of feedback loops. We can't like recreate that ovarian brain conversation. I mean, maybe some people are out there trying to see if we can like extend longevity in our ovaries, so that conversation doesn't falter. But right now we've got a pretty blunt tool which is just like slap more and more and more and more estrogen in and see if it helps. And right now, weirdly, because you would think that the logic would be that if you put more in you would cure brain fog or it would go away. And that's not always what we see in everyone, in some women, they say, yeah, sure it helps. And maybe if what it's doing is meaning you are sleeping well at night again because you haven't got your hot flashes and your night sweats and you were always a good sleeper and you've had your sleep disrupted for a while and you're starting to sleep again and it was directly due to that, then that's great For other women and I'm a great sleeper.
Dr. Sarah McKay:I was on the pill for many years and I loved it and I feel like I had a sudden menopause because I came off it at the beginning of last year because my GP was like you're 49, you're a bit old. I was like please, let me. She said, no, let's see what happens. 10 days later I was like I can't sleep. I have I've never, I've never not slept. This is.
Dr. Sarah McKay:It was like about one week and my husband's like I think you should actually go back. So I was like back there and I, the last three weeks have been terrible. I haven't been sleeping, I've been waking up. No, I've had flashes. So I like had three weeks of symptoms and I was just like this is ridiculous. Can I go back on the pill? And she said, no, well, let's try you on hormone therapy. It doesn't quite touch the sides in the same way, let me say that. The same way. Let me say that because the dose of synthetic estrogen that I was on, which clearly suited me well, obliterated any symptom that I had. And you know, a little bit of estradiol gel, kind of mostly does its job, does the job, but not quite as well. But there's sure there's other risks and benefits for both of those decisions. That is my, that's my personal experience anyway.
Dr. Sarah McKay:I started sleeping fine again, slept through that. Occasionally I'll wake up, but not like I was then with this feeling in my legs. I was so fuzzy and foggy because I hadn't slept. Now I sleep fine again, but I still do. The weird word switches all the time. So if we were to have done cognitive testing on me and picked up the word switching, the hormone therapy hasn't made a dash of, hasn't touched the word switch, and this is often what we see is that women will. We can measure in some women changes in cognitive scores and then the hormone therapy isn't really kind of budging it and it may be that it's just. The brain is a whole lot more complicated than simply adding hormones back in and fixing brain fog. So that's quite disappointing and confusing.
Dr. Sarah McKay:Yeah, so hormone therapy is a maybe Hormone therapy is really good for vasomotor symptoms and it's really good if your vasomotor symptoms are waking you up at night. But if you've still got brain fog after that, it doesn't necessarily always help and we don't know why. If you are much younger you're like, say, you went through menopause, your premature ovarian insufficiency, before 40, or you went through early menopause by 45, there is a case to be made that it can help your overall cognition if you keep taking it, and that's probably just to do with the lifetime kind of volume or dose that you are taking in of estrogen until around age 50. We don't, we don't know why this is the situation and then in some women, even if they are taking it, they're not sort of seeing an improvement. And this is why it is so important not to just rely on just like kind of this one solution.
Dr. Sarah McKay:Forget about all the other things to do, because our brains are living in a body and a world with a mind attached and that's why we've got to do all of the other things too. We've got to do all of the sleep hygiene things. I'm sure you've had sleep doctors on here talking about all of the sleep hygiene measures. You've got to do all of the things to take care of your cardiovascular health, so not just your heart but your blood vessels as well, because they feed your brain. So all of the things that you would do to promote good cardiovascular health and metabolic health. So that is, things like you do eating a good, healthy diet, making sure that you're doing lots of exercise, making sure that you are finding ways to manage your stress, because if you're more sympathetically dominant for want of a better word what kind of ways are you finding to physiologically calm your body down when you're feeling stressed? How are you connecting with other people? Are you remaining socially connected, intellectually connected? Are you making sure that all the things that can harm your brain, like hearing loss, which makes you become isolated, vision loss, which makes you become isolated, air pollution try and avoid head injuries, don't go climbing ladders and cleaning the gutters out All of the things We've just got to kind of throw the whole gamut of brain health, general health, well-being at the problem, and then maybe you might sort of see a few little gains here and there.
Dr. Sarah McKay:And then there's a ton of other things that I also think we can do. There's a little bit about the attitude change as well around mourning the loss of your ability to quickly recall the name of that woman, the marriage, the guy in the movie where the guy was the doctor, whoever that was. But think about the upsides of having an aging brain and the wisdom. Can you have a little bit of a mindset? Shift around not mourning what you've lost but thinking about what you've gained, and then just put in place, like I live and die by my calendar, everything is diarized.
Jenn Salib Huber :You only have one, I have several.
Dr. Sarah McKay:I am one of these people that my husband thinks this is hilarious. If I go onto my alarms, I like have like hundreds of them Because I just set one and I just like every like five minutes of the day I set alarms all of the time. I write everything down, so I've got backups as well. But none of this is really new advice. This is the kind of same advice we would give to a teenager who's studying for exams. The same advice we would give to someone with an ADHD diagnosis on how to manage their brain and their mind and their time and their life. It's just another phase that we're going through in which we need to provide as much support and structure as possible and maybe some HRT, you know, rub your gel into your arms or whatever you're using.
Jenn Salib Huber :What about? So here's a hot topic question. It'll probably still be a hot topic when this comes out. What about creatine? So this is the latest. Anything about that?
Dr. Sarah McKay:okay, could not answer a single question on creatine.
Jenn Salib Huber :I think that actually is the best answer. I think that if somebody who is an expert in brain health doesn't know about creatine, then I think that's the answer that everyone needs to know I'm not really big into supplements.
Dr. Sarah McKay:I'm more into like just eat the food You're in the right place.
Dr. Sarah McKay:Yeah than the supplements. I do think it is very hard to separate out the messaging that is currently floating around um and I mean from people who you know from the commercialization of everything. It's very it's hard to cut through that. And and diet, in particular that's your jam is not necessarily something I pay masses of attention to, because I'm not really interested in the supplement conversation. I just kind of think it's a bit boring. I don't know. I just think that there's way more interesting things to talk about in terms of brain health should you?
Jenn Salib Huber :well, one of the things that I, you know, before we just kind of wrap this up a little bit, just to kind of add, um, you know, my, my voice into this about nutrition, um, you know, one of the things that I think is so important is for people to recognize that it's the patterns of eating over our lifetime that matter. Goodness could not agree, it's not, it's not the meal that you had.
Jenn Salib Huber :50 times in a month not the blueberry, not the blueberries Exactly. And so I describe nutrition and mental health, which extends to brain health, as the scaffolding. You know you can scaffold your brain with nutrients and nutrition and patterns of eating, but you're still going to have environmental factors, genetic factors, the other determinants of health that are going to play into what actually happens right. Yeah, so we put so much pressure on you know things like poor celery and blueberries.
Dr. Sarah McKay:Well, I feel so sorry for blueberries or walnuts, just because they look like little brains.
Jenn Salib Huber :So if anybody is listening and thinking, okay, but what about nutrition? I have a whole section in each of right, I mean the patterns of eating we we, we.
Dr. Sarah McKay:And if, like you're, you study, and not that I study ecology, but I just read as an aside I went to antarctica earlier this year with a bunch of women scientists. It's like really extraordinary. We're talking about ecosystems and ecology and how everything's this, like the plankton is you know, there's less plankton and so the knock-on effects it has on this whole web of ecology of all of antarctica and all of the oceans. When, like, there's changes in numbers of one little like kind of shrimp, um, or plankton or whatever they are. I don't even know because it's not my field, they're probably completely different plankton and shrimp I think shrimp and plankton, and shrimp, I think shrimp and plankton.
Dr. Sarah McKay:Anyway, like that is a simple ecosystem compared to like our brain and our body as it moves through life. Right, and, like you say, it's like about the patterns, it's not about each of these individual factors and we're trying to go. Well, if I put creatine in and some hormone therapy, are we just going to see this lovely knock-on effect? And you're not, because as soon as you change one factor it's going to change a hundred of others and then they're going to have knock-on effects because there's all of these feedback loops. There's no straight lines. We can draw them in the textbook sometimes if we're looking at little molecular pathways, but overall health doesn't work like that. It's this complex ecosystem, this intricate web, and it changes across our lives. Just like you've said, it's an eating pattern. So I think the same can be said about approaching brain health as part of this massive ecosystem.
Dr. Sarah McKay:And there's always, like, the gut brain people, and then there's the heart brain people, and then there's the heart brain people, and then there's the hormone brain people, and then there's the, the social brain people and the sleep brain and the night dark, you know, and the physiological breathing people and the I don't know. There's some reading books, there's the other that I haven't mentioned right, there's every. There's all of these links to the brain, but the brain's trying to. The brain is like taking it all in. The brain isn't going. I'm only going to listen to one. The brain is just like processing all of this data and this information, making meaning of it and figuring out what to do next. It's not specializing one over the other just because it got popular on social media.
Jenn Salib Huber :I cannot thank you enough for spending this time with me. I think this is actually going to be the longest podcast we'll have recorded, and I feel like we just scratched the surface.
Dr. Sarah McKay:That's my inability to be short-winded.
Jenn Salib Huber :No, but everything that you said needed to be said, Because the people who are interested in listening to this know that I try and bring people on who will be that filter to this, know that I try and bring people on who will be that filter. So if you're somebody who's listening and you're thinking I don't know what to believe and I don't know what's happening, this hour hopefully will have helped them filter through that it's not all bad.
Jenn Salib Huber :It's not necessarily going to be this disastrous thing. Brains aren't broken. Brains aren't broken and it gets. It gets better, it does, and there are some things the things that you do to promote your overall health can also support you as you go through this brain transition.
Dr. Sarah McKay:But there's no magic bullet, regardless of what you see on the internet no, no, no, thank you, thank you, and and if anyone has got all the way through to this point, um, I commend you and thank you for listening to my long-winded neuroscience lectures.
Jenn Salib Huber :I could listen to you talk all day, so I'm sure that this hour went by as quickly for listeners as it did for me. But now we are at the final question, which I always ask my guests what do you think is the missing ingredient in midlife?
Dr. Sarah McKay:A little bit of not a little bit a big dose of humor. People need to stop being so pious and need more, need a bigger sense of humor. They just need to laugh at themselves, at their belly, at their brain fog. We've just. We are so busy being pious and serious and health and well-being. It's almost like this kind of very serious religion and it's just so unfun and I don't like that. So I just think we need some more fun.
Jenn Salib Huber :I'm going to share a little story. I'm going to share a story just from this morning and I'm going to tell my daughter about this after. So, our paper recycling. This is a brain fog and a humor moment. Our paper recycling gets picked up once a month here in the Netherlands. So I have all the reminders set on my phone because you don't want to miss it.
Jenn Salib Huber :And this morning I woke up and for some reason thought, didn't check, thought, oh my gosh, it's Tuesday morning, put the recycling out. So I go out and I put it out, and as I get out there I realize mine is the only bin on the street, so I leave it there. I come back in the house, I check the calendar oh no, it's actually next Tuesday. And I laughed hysterically and like just laughing as I go and get this and my my 18 year old almost 18 year old was like mom, you were laughing. That was a really weird laugh. That's what a teenager would say. I'm like I'm just laughing at myself because it was hilarious, right. So I think that humor is just.
Dr. Sarah McKay:I mean, laughter is the best medicine so if you can't laugh, yeah, yeah, taking it seriously, which is important.
Jenn Salib Huber :But serious doesn't have to be humorless yeah, so we are going to put all of the links um to you and your incredible book, which is the women's brain book, which has now just been released for its second edition we've got a new pink cover.
Dr. Sarah McKay:I love it. I love the colors.
Jenn Salib Huber :Highly recommend highly orange, orange there for the dutch um and we will have links and your instagram is fabulous, so anybody listening, I strongly suggest that they follow you. Thank you so so much for this conversation. That was good fun. Thank you thanks for tuning in to this week's episode of the midlife feast for more non-diet, health, hormone and general midlife support. Click the link in the show notes to learn how you can work and learn from me. And if you enjoyed this episode and found it helpful, please consider leaving a review or subscribing, because it helps other women just like you find us and feel supported in midlife.
