[ad_1]
MS. STEAD SELLERS: We’re very pleased to have you.
MS. STEAD SELLERS: So I wanted to start, Maria, with you. You had some news yesterday. You were at the White House–
MS. SHRIVER: That’s right.
MS. STEAD SELLERS: –announcing a new initiative. Tell us what that was all about and what you expect the impact to be.
MS. SHRIVER: Well, that was a game-changing day, I believe, for women’s health in general. It was the first ever presidential initiative on women’s health research–
MS. STEAD SELLERS: First ever, wow.
MS. SHRIVER: –in our history. And what it does is it charges the federal government for the next 45 days to look at where we’re spending money on women’s health, where we could do better, where the gaps and the holes are. And it also notifies that the branches of government need to work holistically.
In 45 days, we’ll look at what they came back with, and then I hope in the State of the Union, the president will talk about the plans moving forward.
But the fact is that NIH only spends about 10.8 percent of its federal budget on women’s health. We’re 50 percent of the population. So that figure, in my mind and I think in every woman’s mind, is inexcusable. We need to raise that. We need to understand women’s health spans. We need to understand what’s happening in their bodies from birth all the way through old age. We need the data so that women who are my age when they go into the doctor, they can get answers as opposed to “we don’t knows.” And our hope is that this will change the trajectory of women’s lives.
MS. STEAD SELLERS: Such a good point. And, Sharon, it brings me to one to you. Women have historically been left out of research, and even during the pandemic, during those clinical vaccine trials, pregnant women were omitted from the vaccine trials. How did we get here, and why is the White House, in your view, now paying attention, apart from Maria being the leader?
DR. MALONE: You know, it’s an interesting story of how we got here, because I think, particularly for women in menopause, the narrative was different. And I practiced for 10 years before this infamous study. The Women’s Health Initiative was announced in 2001. We were actually taught that menopause was a time of life that women were at risk for certain conditions, primarily cardiovascular disease, in addition to all the symptoms that women–that you normally associate with menopause, like hot flashes. But we actually prescribed hormone therapy for disease prevention, which was cardiovascular disease, and it was only when that study was introduced–actually, when it was stopped in 2002 that hormones became the enemy.
And unfortunately, in those 21 years since that study was actually stopped–and it was a study done by the NIH, which is why I think it’s so important that the NIH come back and readdress this–is that in those 21 years, an entire generation of women were disadvantaged because they were–they thought of hormone therapy as the enemy, and an entire generation of physicians also did not get the education that they needed to be able to advise women in midlife.
MS. STEAD SELLERS: So, Lisa, you’re a neuroscientist. You know more than probably anybody about menopause and the brain. What you got you into that field of work? How did you enter that?
DR. MOSCONI: I entered the field of menopause a little bit in a slightly unusual way. I was studying Alzheimer’s disease. I specialize in Alzheimer’s prevention, and I do specialize in women’s brain health, which let me tell you, I don’t have a lot of competition, and that’s fine.
DR. MOSCONI: We were working with Maria and the women’s Alzheimer’s movement, and the research is NIH-funded. And we were trying to reconceptualize Alzheimer’s disease not as a disease of old age but as a disease of midlife. Alzheimer’s disease is a disease of midlife with symptoms that emerge and manifest in old age, and what we have shown is that that timeline is a little bit different for women than for men as in the signs of Alzheimer’s disease, the negative changes that occur in the brain can be detected earlier on in life for women.
So we can do brain scans to try and find these changes that tend to coincide with the menopause transition. So that’s why we’re now looking at menopause as a neurologically active state–
MS. STEAD SELLERS: Right.
DR. MOSCONI: –that may increase a woman’s risk of Alzheimer’s.
MS. STEAD SELLERS: Maria, you have daughters, and I’m wondering, as this research emerges, how their thoughts about menopause may have changed from conversations when you had years ago and how they talk to their peers about it.
MS. SHRIVER: Well, I think I didn’t have any conversations with–
MS. STEAD SELLERS: Right.
MS. SHRIVER: –my mother about menopause.
MS. STEAD SELLERS: Right.
MS. SHRIVER: So there’s a sea change that I think–
MS. STEAD SELLERS: And now they have the menopause mother.
MS. SHRIVER: Right, yeah. So I think they now, I think, feel like they know a lot about this subject.
MS. STEAD SELLERS: [Laughs]
MS. SHRIVER: But I think what’s important is to step back and realize that this is a very new conversation.
MS. STEAD SELLERS: Right.
MS. SHRIVER: Women’s brain health, menopause, women’s health, period, is new, and we’re decades and decades behind when it comes to the research, when it comes to the narrative around our lives. So this is an urgent political issue. It’s a human rights issue. It’s an economic issue. Women drop out of the workforce due to menopause, due to depression, due to anxiety, due to all kinds of things that we don’t know why they have that, why they’re experiencing this.
When I got involved in Alzheimer’s, because my dad had Alzheimer’s, everybody said it was just a disease of old age. There was nothing you could do, and that women only got it more because we lived longer. That’s all changed, and we’ve changed the narrative on Alzheimer’s. We’ve put women front and center. We’ve said we have to study women now at a younger age to determine what’s happening in midlife and beyond. We can’t tell you–and all of these things depend on research, which we don’t have.
MS. STEAD SELLERS: So that takes me again, Sharon, to you. You mentioned the change thinking around estrogen, but younger women coming into menopause, are they thinking about hormone replacement therapy differently than maybe ten–you know, what’s the conversation you’re seeing? Because you practice–
DR. MALONE: You know, we’re honestly changing the conversation, and I think for the women of my generation, many of them have missed out because they, again, have these misperceptions–
MS. STEAD SELLERS: Right.
DR. MALONE: –about hormone therapy.
MS. STEAD SELLERS: Right.
DR. MALONE: The younger generation–and I say these Gen X-ers and millennials–they are not buying into this notion that we should just–you know, we should become invisible as we age.
And there are real–there’s real scientific data about hormone therapy that has been there in front of our eyes forever and we’ve ignored, and that’s the unfortunate thing, because when I say what this study did, the Women’s Health Initiative, it really took the most effective solution that we had, not only for the symptoms of menopause, but as we’re coming to find out, not only that we’re finding that the data is very convincing as far as cardiovascular disease and osteoporosis.
And what we cannot really ignore is also not only the fact that as women age, but as women of color, we are also affected differently. And we are more at risk for the conditions such as Alzheimer’s and heart disease.
MS. STEAD SELLERS: Why? What’s–
DR. MALONE: Well, you know, isn’t that a question?
MS. STEAD SELLERS: Right.
DR. MALONE: That, you know–
MS. STEAD SELLERS: This question comes up the whole time.
DR. MALONE: The amazing thing to me is that even during–you know, as I started delving more into menopause in the past three years–I was reading Lisa’s book. I did not realize that two-thirds of the–two-thirds of the people with Alzheimer’s are women. I had no idea. I did not know that Black women have twice the risk of developing Alzheimer’s as White women. Those were things that were knowable.
MS. STEAD SELLERS: Right.
DR. MALONE: And I think what is unconscionable to me is that we knew that that was the case, but no one has bothered to ask the question as to why, and more importantly, what are we going to do about it?
MS. STEAD SELLERS: And what it looks like, because I’d love to ask Lisa now about what happens to a brain before and after menopause and what you can actually visualize. Maybe you could help us think through that.
DR. MOSCONI: I’m happy to. So we have some slides and–we have–yes. Okay, good.
MS. STEAD SELLERS: Okay. That is a brain.
DR. MOSCONI: So that is a brain imaging. So my background is in neuroscience and nuclear medicine, which is a branch of radiology, and this is the kind of images that I–can we go back one second? But if not, it doesn’t matter. So these are brain scans, positron emission tomography scans. If you can just stay on this light for one second, I just want to tell you how to read this image.
So this is a very healthy-looking brain, and we’re looking at brain energy levels of the way that the brain takes up glucose, a simple sugar to make energy. And this is the way you want your brain to look like when you’re in your forties, like this woman was when we first took her brain scan. You want to have a lot of red all around the brain, inside the brain, the little butterfly shape structure in the middle. There is blue, which is fine. It’s fluid. There has to be fluid inside a healthy brain, but you really want to have high brain energy levels, so a lot of red.
And now if we can start the animation, this is what happened to this specific brain as this woman went from before menopause to after menopause, and I think that the change is quite clear, right? The red turns yellow. The yellow turns green. So this is a drop in brain energy levels, which at least in our studies with hundreds of women, we have estimated to be about 20, 30 percent.
Now, what does that mean? Is the brain getting sick? No. The brain is going through a transition. So menopause is a neurologically active state. It changes your brain as surely as it changes your ovaries, but the brain connection has been widely underestimated in medicine, I would say. And these changes could potentially explain the symptoms of menopause that Sharon was talking about. So when women say they’re having hot flashes, night sweats, but also insomnia, depression, anxiety, brain fog–everybody dreads the brain fog, the memory lapses–those are signs of menopause that have nothing to do with your ovaries. They start in your brain. Those are signs that your brain is changing because of menopause.
MS. SHRIVER: Can I just say, what’s really important is that millions of women go to their doctor in midlife with these symptoms, and they’re put on SSRIs, or their doctors don’t associate these symptoms with being perimenopausal, right? So this is a conversation that doctors need to be brought into–
MS. STEAD SELLERS: Right.
MS. SHRIVER: –that women need to understand that menopause is not just a bodily change, right, that it’s not just about losing or getting intermittent periods. It’s about what’s going on in your brain.
MS. STEAD SELLERS: Which makes me ask Sharon, where does estrogen fit into this? Do we have any clue about the impact estrogen was having on those incredible slides we saw?
DR. MALONE: We actually have a lot of information about estrogen, because contrary to popular belief, estrogen is not new.
DR. MALONE: We have known about estrogen. Once again–once again, we have used it in some form or fashion consistently for the past 80 years. I mean, the Premarin which was the drug that was used in that large study was patented in 1942, and so we have probably more data about estrogen than probably any other drug that’s been in continuous use.
DR. MALONE: So what we know is that estrogen is the most effective treatment for those symptoms of menopause, the hot flashes, the mood swings, the sleeplessness, but what we have found is that not only is it just the short-term benefit, but there’s a long term. And we have known, again, that it decreases the risk of osteoporosis.
We have found that treating a hot flash, which, you know, is often used as a sort of comical relief for women in menopause, treating hot flashes actually improves your brain health, because what we have found is that women who have hot flashes are also more at risk for cardiovascular disease, and they have more changes in their brains which are indicative, that could be indicative of Alzheimer’s.
So the estrogen story is not new. Unfortunately, it has been just sort of–
MS. STEAD SELLERS: Right.
DR. MALONE: –tucked away for a while, and what we’re trying to do is to get people to understand that we don’t necessarily have to reinvent the wheel–
MS. STEAD SELLERS: Right.
DR. MALONE: –to address some of these issues, because we have known and we have dealt with these medications for many, many, many decades.
MS. STEAD SELLERS: So let me take on another question with you, Maria. Alzheimer’s has always been sort of thought of as an old person’s disease, and you’re reversing that. What do we know about the prevalence and predictions for it among younger women? What do we understand about that?
MS. SHRIVER: Well, we don’t. We don’t know, and that’s why we’re trying to fund research. We don’t know kind of about women’s health spans, period. We don’t know why women are 80 percent of the autoimmune diseases. We don’t know why women are getting lung cancer at double the rate of men. We don’t know. We don’t know. We don’t know. So–
MS. STEAD SELLERS: So you’ve been a trailblazer in this research.
MS. SHRIVER: Well, the women’s Alzheimer’s movement has been–
MS. STEAD SELLERS: Right.
MS. SHRIVER: –trailblazing in funding research into women to try to understand why women are two-thirds of those with Alzheimer’s. As I said, when I started as an advocate and activist in this space, women weren’t even a part of the picture. Lifestyle wasn’t even mentioned. Menopause wasn’t even in the picture. So funding research that into women is a huge game changer that happens across the field.
So I think breast cancer has done a great job of funding research, but there are many things that happen in a woman’s life in addition to breast cancer, right?
MS. STEAD SELLERS: Right.
MS. SHRIVER: And we’re trying to broaden the conversation that there are women, you know, in puberty, in midlife, and beyond, right, and so what’s very important is that women in midlife stay in touch with their doctor. Doctor after doctor says we lose track of women when they’re like 40 to 65, and that is the really important period of a woman’s life to intervene, to talk about hormones, to talk about symptoms of perimenopause, to talk about osteoporosis, to talk about the things that happen to women in midlife that also will set her up to age well.
MS. STEAD SELLERS: Lisa, you know about the brain not only in midlife but also in adolescence. And I’d love to understand a little bit more about what you’re seeing and understanding that informs this research based on the brain at adolescence and then during menopause. You’ve seen key differences there.
DR. MOSCONI: Yes. And my daughter is eight, and she can talk to you about puberty and menopause like all day long about how they change in the brain.
MS. STEAD SELLERS: I love these new conversations.
DR. MOSCONI: And we’re talking about the younger generation. You have to start young.
MS. STEAD SELLERS: You have to start young. [Laughs]
DR. MOSCONI: We started when she was four and she was throwing tantrums, so yes.
There’s a system that connects the brain with the ovaries that we are born with. The system is called the neuroendocrine system. So it connects the neural part of your brain, neural system, with the endocrine system, the hormonal system. This system gets activated during puberty, during adolescence, and it gets deactivated after menopause. And it’s really this switching, this on and off switch, then creates a bit of a remodeling inside the brain. And I would like to say that menopause is like a renovation project on the brain, and it is not all negative. So we have the symptoms that we’re familiar with. We have some medical risks that can come up. But just like puberty and also like pregnancy, these are transition states that also bring a lot of resilience and new mental and neurological skills.
And something that we really like to underline is that women after menopause have exceptional empathy and cognitive mastery and emotional mastery, which is a very specific ability to turn down your reactions to negative stimuli. So if something bad happens to you after menopause, you don’t care as much.
DR. MOSCONI: You deal with that a lot better.
DR. MOSCONI: And it’s so important.
MS. STEAD SELLERS: So, Sharon, given this, why is the narrative around menopause so doom and gloom?
DR. MALONE: Well, you know, that is the–that is a narrative that I think has taken hold by this whole notion that as women, as we age, we become more invisible. Who cares what happens to you after menopause?
I think that, thank goodness, due to women like Maria Shriver, Michelle Obama, there are so many women out there who are showing that menopause and the menopausal phase of life of which women will spend a third of their lives, if they’re lucky, is a time of great joy and productivity. I mean, just as you said, you don’t–there are a lot of things you don’t care about when you’re 60 that you cared about when you were 40. And we have got to really sort of–I say–almost say rebrand menopause, because there are a lot of us that are out there who are postmenopausal. And I think that there’s a–this is a phase of life when we’ve never been wiser. We’ve never been–we’ve never had more experience in life, and to be able to impart that and to not shrink into the background is really our goal.
And I think that the more people that fess up to this and actually come out and embrace it, then I think that women can accept it for what it is, which is a wonderful phase of life.
MS. STEAD SELLERS: So last question that I want to ask each of you, we have a new woman–the 17th director of the National Institutes of Health is a woman.
MS. STEAD SELLERS: And, Maria, you’ve taken a leadership role, but what does it mean to you to have a woman taking on that very powerful role in scientific research in this country?
MS. SHRIVER: Well, she was in the Oval Office yesterday with us for the signing of this memorandum, and I hope that she will put–just like Bernadine Healy did before her, put women at the center.
Obviously, there is a lot of institutes at NIH, but I’m gunning for an institute that has women’s name on the door. I’m gunning for an institute that is able to grant in the billions to look at women’s health span.
And I just want to say that menopause, if you’re lucky enough to go through it, which means you’re alive, right, and age into your 60s and 70s or 80s, to have a good 60s, 70s and 80s, you need to be healthy. And too many women in this country don’t have access to health care. They don’t have access to maternity wards. They don’t have access to what they need in order to be healthy in their 60s, their 70s, and their 80s. And this is critical. Prevention, good health should not be something for the 1 percent. It should be available and accessible and affordable to all, and therefore, we need research. We need young women and young doctors and researchers coming up that prioritize or at least equalize women’s health and don’t treat women like little men, that focus–
MS. STEAD SELLERS: Another phrase for that. It’s not quite as polite, but it is the one used.
MS. SHRIVER: And we were saying yesterday, women are sick in this country and they’re tired, and they’re sick and tired of being sick and tired.
MS. STEAD SELLERS: Right.
MS. SHRIVER: And women are parenting. They’re providing. They’re caretaking. They’re caregiving. And you need your health and your strength to do all of that, and you need to start at a very young age so that you can get to your sixties and seventies and eighties and become an advocate and an activist for other women.
MS. STEAD SELLERS: An advocate and activist, thank you.
MS. STEAD SELLERS: And I’d love to hear the view from two scientists there. We have just a minute, each of you. Sharon–or a little bit less–tell me, what does that women’s leadership mean for you as you’ve seen people coming up through your labs? Are they inspired?
DR. MALONE: I think it’s important, because empathy matters, you know, and it matters because it matters to us personally. I think we need more. We need more diversity in the researchers because you will find things interesting that honestly will affect you.
And I think that there’s no coincidence that the Women’s Health Initiative, the same study that we talk a lot about, was actually initiated during the time of the first female director of the NIH, Bernadine Healy, in 1991. Now, she didn’t get a chance to see it through, but her intentions were good. It was the first time that there had ever been a study of that magnitude into the health of women, in postmenopausal women.
So yes. So I am very encouraged by this because I think that she will bring a perspective to the NIH that has been absent, and I think that we also have the grassroots support now from women who now understand how we have been ill-served in the past 20 years and for time immemorial. And so I’m–I think of this as a very optimistic time, and I think Maria is exactly right. We have got to make sure that all women have access to the information, and it shouldn’t be just for the few.
MS. STEAD SELLERS: And you both reminded me that I misspoke in calling her the first female director, but she’s the 17th and a very key woman.
Lisa, right at the beginning, you were talking about essentially female mentorship. So what does it mean for you as you see younger scientists coming along to have this great woman leader in Washington?
DR. MOSCONI: It gives me hope. As a scientist, it’s really hard to get funded to do this kind of research, and I think it’s important to realize that women are half of the population. All women, God willing, will go through menopause. All women have brains, and three out of every four women experience neurological changes during menopause. But menopause research receives less than 0.08 percent of the entire budget, the federal budget, for health care. So I’m hoping that this changes. I’m hoping that scientists will be allowed to do research on women’s brains and menopause, because right now we really have very little incentives.
MS. STEAD SELLERS: Can I just end by saying I’ve never had so much fun before talking about menopause?
MS. STEAD SELLERS: I want to thank you, Maria, Sharon, and Lisa for joining us here on stage.
MS. STEAD SELLERS: And we’ll be right back soon, so please stay with us. Thank you for being here.
[ad_2]
Source link
