The Dr Louise Newson Podcast - 62 – How hormones change your brain - Dr Jay Jagannathan

Episode Date: April 30, 2026

What if the symptoms women are told are down to stress or hectic lifestyles are actually coming from hormone changes in the brain?In this episode, Dr Louise Newson is joined by board certified neurosurgeon, Dr Jay Jagannathan, for a fascinating and eye-opening conversation about the role hormones play in brain health.They explore what’s really happening during times of hormonal change such as perimenopause and menopause, and what’s driving symptoms such as memory problems, low mood and brain fog. Together, they unpack the science behindthese changes, including how hormones influence brain structure, neurotransmitters and inflammation.We hope you love the podcast. If you enjoyed this episode, please make sure to follow us and leave a 5-star rating and share it with someone who needs to hear it.LET'S CONNECT  Subscribe here 👉 https://www.youtube.com/@menopause_doctor Website 👉 https://www.drlouisenewson.co.uk/Instagram 👉  /@drlouisenewsonpodcast  LinkedIn 👉    /https://www.linkedin.com/in/drlouisenewson/ TikTok 👉   / https://www.tiktok.com/@drlouisenewson Spotify 👉 https://open.spotify.com/show/7dCctfyI9bODGDaFnjfKhg  LEARN MORE Download my balance app 👉 https://www.balance-menopause.com/balance-app/Get tickets for my new theatre tour, Breaking the Cycle 👉 https://www.nlp-ltd.com/dr-louise-newson-breaking-the-cycle/ Preorder my new book 👉 https://bio.to/ThePowerofHormones

So Jay, I'm very excited for this podcast. We're recording it on a Sunday night because you're super busy. I'm quite busy. But you are a neurosurgeon. So you are the creme de la creme of medicine. I should be bowing and cursing in front of you. Well, thank you for having me. I'm a big fan of your podcast.

And so I think the value you provide, you know, particularly for women in a perimenopausal phase. My grandmother passed away of a heart attack that went undetected after menopausea. Obviously, after menopause, my mom is early, developed breast cancer shortly after menopause. I think it's very critical, valuable information. And I really applaud your work. So it's an honor to be here. Thank you. Well, I always try and think differently about things because I think it gets people thinking in different ways.

And that's what I'm doing about hormones, about menopause. But some people listening know that I actually wanted to do oncology many years ago. I wanted to do cancer medicine. and I only changed my career for lifestyle because I've got three children and I wanted to see them grow up. But my father actually died of a glialostomus so a brain tumor when I was nine.

And I remember going to the operating theatre. I was so desperate to meet the, well, I met him when I was nine, but didn't really remember him, but the neurosurgeon, Professor Watkins in London. So when I was a medical student, I went and watched him operate and met him and spent time with him.

And, you know, it's incredible. when you see someone's brain. Like, you do it every day. But, you know, for most of us, it's an area that we'll never see. And we don't think about often, I don't think. We take our brains for granted. Yeah, I think it's one of the biggest privileges for me in medicine is being able to operate on that part of the body.

Because I think every part of the body, obviously, is important. But to kind of be in an area which controls, you know, so much of your personality, everything that you know about a person is truly unique. And it's something you never really lose the odds. seeing that, no matter how many years you've done it for. So it's a privilege. And I think the other part, you know, with respect to things like GBM is our knowledge, you know, the prognosis for GBM in the last, you know, 100 years with all the advances to robotics, AI, hormonal therapy, you know, has really hasn't increased substantially. You know, it's gone up maybe about four to six

months over the course of many, many years. So it teaches you how much we have that's left to learn. And I think, you know, when we look at topics such as what we're discussing here, you know, effects of hormones on brain health, on chemistry, on tumors, things like that. I think what we're talking about today, five years, 10 years will be completely different from what people will be talking about then. Yeah, I hope so. I'm very interested in the role of hormones throughout our body, but especially our brain. And I'm also very interested in inflammation and about how our hormones can reduce inflammation

in our bodies in our brain as well. But a lot of people think once our brain has developed, there's a lot of talk, isn't there? about children, adolescents, their brain, how it develops. And then people think it's almost quite stagnant after then. But there's neuromodulation going on all the time, isn't there, in our brain? You know, our brain is constantly rewiring. The brain is constantly rewiring. There's certain parts of the brain, obviously, that tend to be more fixed.

There are certain parts of the brain that tend to develop over the course of age. And the size and the shape of the brain changes too. You know, with all of us, as we get older, the brain mass tends to decrease. There are changes in proportions of areas such as gray matter and white matter that happen as we get older as well. And there are effects of hormones such as estrogen on those factors, I'm sure we'll discuss in this podcast as well. And even aside from the structure, there are areas in the brain such as fluid spaces, the ventricles, things like that, that change in terms of size and in terms of compliance as we get older. And all those have significant impacts in terms of cognitive function and in terms of behavior and other things. Which is so important to know that, you know, we can constantly improve our brain function.

We can improve the way the cells work and also the communication between different areas of our brain because different areas of our brain have different roles, don't they? Yeah, exactly. You know, I mean, every part of the brain obviously has an extremely valuable role. I mean, the frontal lobe is an area that kind of controls, you know, impulsivity. You know, the cognitive thinking, what we think about, personality, stuff like that. You know, there are areas of the brain such as a temporal lobe. that controls more language, more spatial orientation, things like that.

Brain stem, which controls critical functions such as breathing, things that we don't even know that we're doing, but are absolutely critical for life. Other important connection is that within these parts of the brain, there are different types of neurotransmitters. Neurtransmitters are the chemicals, almost the currency that the brain uses to communicate with different parts. And these parts play significant roles in the overall internal milieu of the brain, as well as communication with external hormones within the brain itself.

And that also plays a role. And those shifts also play a role. in terms of how our brain develop over the course of both in our youth and in our, as we get older. Now, the one thing that is true when we are very young is the brain's capability of remodeling is a lot more rapid. So you have something called plasticity, which is the ability of these premature cells to really be able to remodel. We don't fully understand that, obviously, but certain areas of the brain to hippocampus, the occipital lobe are able to rapidly remodel. For example, in a child with a brain tumor, I'll never forget from my training,

we took out a tumor in the occipital lobe of a child that encompassed basically the whole occipital lobe. And in an adult, if you had taken that out, the patient would have been blinded for life. But this child had it in infancy. And by the time she was two years old, was able to have pretty much normal vision. So there is a degree to develop there. But obviously, that does change as time goes on. But I think you're absolutely right that the overall functionality of the brain is incredible. And it does change.

And, you know, that's something that we utilize for our benefit as well in terms of treatment and other things as patients get older. Yeah, and so when I was experiencing my own perimenopoles or symptoms about 10 years ago, the biggest thing that, well, the thing that worried me the most is my brains didn't function. You know, I was really struggling to remember. I couldn't multitask. I couldn't remember drug doses. I couldn't remember patient names. Really basic things that, you know, were bread and butter, really to me.

But it was almost like thinking through treacle. It's really, really scared. And, you know, we've now got data from hundreds of thousands of women who use our free balance app. And the commonest symptoms are poor memory, low mood, irritability. You know, it's the brain that's affected most with hormonal changes. Sure. So there's an umbrella. You know, I'm listening to your podcast. You use the term brain fog, which is a common term that people use in relation to menopause. And there are several areas that may play a role in that.

I mean, I think, number one, decrease in estrogen level has been. shown to affect glucose levels in the brain. As we know throughout the body, glucose is an extremely important tool that the body uses for energy production. That's extremely important in the brain as well. That's why when somebody, we have an athlete and, you know, they're kind of losing the energy, give them a drink, a Gatorade or something to help with that. So that's one factor there. Studies have also shown that structurally the brain changes with respect to decrease in estrogen. Specifically, studies in the past couple of years looking at functional MRI treatments have shown that gray matter matter areas in the brain, the gray matter is the area that contains

neurons, the neurons are worth fire that help us control the brain activity, the supposedly the circuitry of the brain itself, that those tend to diminish as the estrogen levels tend to go down. And then there's also changes that happen with respect to neurotransmitters themselves. Estrogen has been shown to have a stimulatory role with neurotransmitters, such as acetylone, with serotonin, which dopamine, which are extremely important in terms of pleasure responses, in terms of alertness, in terms of activity. And similarly, interestingly, progesterone levels have been shown to be correlated with GABA, which is an inhibitory neurotransmitter.

They've been shown to be related to things like relaxation and stuff like that. So that combination of effects, clearly there is a relationship between hormonal changes and both the brain chemistry and the brain structure that happens after menopause that play a role in many of those symptoms you discussed. Yeah, which is so important because once you understand the basic neurophysiology of hormones, it makes it so much more obvious why people are experiencing symptoms. And, you know, the way that the neurotransmitters work together, a lot of people will have heard of serotonin and dopamine,

but don't realise that actually all three hormones, progesterone, estradiol and testosterone, you know, their levels really can change the levels of neurotransmitters such as dopamine and glutamate, acetarcolin and so forth. And so there's no surprise that we have so many symptoms affecting our brains. Absolutely. Yeah, I think there's definitely a relation. I think obviously the structural and the functional relationship play a role as well. So I think these changes in neurotransmitters likely also play a role in terms of how the gray matter changes and stuff like that that we see as well.

And I think as the technology with the subject imaging improves, and I think that's the main thing we're seeing now in terms of MRI technology and the ability to kind of link with AI, the functional and the structural aspect, I think we'll see more of this data coming to light. Yeah, which we need to really, because, you know, one of the problems is that makes me feel very sad at least is that women aren't believed. You know, if I had a rash, I could show you my rash and you could diagnose it, you could give me sympathy. If I tell you that I'm not thinking clearly, you know, is it because I've just had a bad night's sleep or is there something structurally going on? And a lot of people are very scared of, you know, am I missing something else going on in the brain? And lots of women come to us and think that they have dementia. But, you know, there are lots of conditions in the brain that can cause memory problems, personality changes as well, aren't there?

Right. So any kind of symptoms that are different from the norm warrants further investigation, you know, irrespective of whether you're a male or woman, gender, race, whatever it is. So it does. I mean, I think one of the things we often see, you know, both you and I in our respective fields when people are embarrassed or shy or they've been told to brush these symptoms aside. And obviously, that's not the right answer. I mean, I think nowadays, one thing we have nowadays that we didn't have even 20,

years ago is we have the ability to order testing and ability to investigate these things much better than it than it was. So I think that's the first part of it. Specifically as it relates to menopause, I mean, I think a lot of those changes, there are treatments. I think the important part about it is that there are maybe not definitive solutions, but there are treatments such as hormone replacement, things like that, that can be a benefit. Absolutely. And I often say to patients, you know, once I've rebalanced your hormones, you know, usually all three actually, progesterone, testosterone and wait for a bit because they can take a while to have an effect and then let's see what else is going on. But I remember reading a few years ago that the first thing or one of

the first thing that happens in our brain if we have a head injury or stroke is that our brain produces more progesterone, men and women actually. And it's very, it's very repairing. It's a very repairing hormone restorative. And it's interesting. I mean, I used to work in a stroke ward many, many years ago and never, ever cross my mind about progesterone and these women, mainly women, that had strokes, but men as well, actually. Right. So progesterone, yeah, I mean, does have a protective effect on the brain. And we talked about the relationship with that in GABA, GABA, inhibitory neurotransmitter, you know, as I think we talked about before we got on the podcast, there's a lot of data

that chose progesterone. So when you look at brain tumors, meningioma specifically benign brain tumors, up to 90% of them will have progesterone receptors. And a progester receptor positivity in meningioma has. has been shown to be correlated with a decreased risk of recurrence. So there is positive effects of estrogen from that, progesterone from that standpoint as well. Yeah, and increasingly we give progesterine to women who've had a hysterectomy.

I feel a bit embarrassed as a doctor for many years. I've been told only give progesterone if a woman has a womb, but actually all women have brains, and we know they, you know, progesterone has an important role in brains. And a lot of people like the effects of progesterone, you know, it's all about getting the right dose and type. And often when we talk about progesterone, people group all hormones together, whereas when I talk about progesterone, I just mean an exact replica of our own progesterone hormone,

whereas there are a lot of synthetic progestogens or progestinns, you say, in the US, which are not the same chemical structure. And they often can really negatively affect people's mood, memory, and so forth. And then you also mention meningiomers, which are benign brain-chamers, which are benign brain-chamers, tumors, but there does seem to be an increased incidence recently. We don't really know why, but there has been some association with some synthetic progestogens, and whether it's because they're blocking the natural progesterone or they have their own sort of almost toxic effect on the brain, we don't really know, do we? I do think you're right in terms of synthetic

progestrons, especially that is a concern because obviously, you know, we know that there may be enough there may be enough variation in terms of the receptor itself that maybe in terms of how it binds the receptor might be different or might bind to a different receptor site. Obviously, these are speculative things I'm saying, but it may have a different effect from a natural progesterine that maybe has a protected effect. Yeah, and we know that, for example, even if you look at the cardiovascular system, progesterone is very good and anti-inflammatory, whereas the progestions increase risk of cardiovascular disease and increase inflammation. And having an Easterer and progesterone receptor is actually good because we have them naturally anyway.

Yeah. So it's, but there's so much we don't know because people have been scared away from hormones, especially when you talk about hormone replacement for the decades. I mean, I don't know how much training you got when you were a junior doctor or a undergraduate about hormones. Probably not enough. You know, I mean, I think the problem, you know, and I feel like neurosurgery, you're so focused on the, on the certain technical aspect of things, you know, the general part.

But, you know, one question I have for you is that some people. Some patients I've talked to or some physicians I've talked to dealing with patients who have these symptoms, these perimenopausal symptoms, advocate early replacement of estrogen. They say if you wait longer, the effectiveness can go down. Is that something you see in your clinical practice? So it's really interesting, actually, because it really varies the response to hormones. And I was taught many years ago that there's some methylation of the receptors, and actually people who have longer without hormones will less likely to respond, especially in the brain.

But then Lisa Musconi's work, who's a neuroscientist, as you know, found that actually when people are deprived from Easterdale for a long time and then have it back, their brain responds very quickly. And I certainly see women, we sometimes see women who are in their 70s, 80s, who've had 20, 30 years without hormones and then deciding they want them often to improve their bone density. But their brain just works again. And so I think it all varies.

And also it's not just the estrogen, it's also the progesterine. But in our experience, testosterone makes the biggest difference to brain, especially cognition and mood, actually. So often it's not until all three hormones are balanced. Okay, okay, sure. And yeah, I think on that note, you know, the other area that we deal with it from a neurosurgical perspective is the effect of these hormones on the spine, right? And there's a lot of data when it comes to things like back pain, you know,

osteoporosis, things like that, how, you know, that I see. kind of later on in the course, where obviously these are factors that you have to take into account with respect to hormone replacement therapy, in particular as it relates to the perimenopausal period, you know, the protective effect of esterines within, in terms of bone density and things like that, as well as changes in estrogen can affect ligamentous, you know, ligamentous factors and stuff like that can lead to things like back pain and things like that in patient tests. And I really pleased you mention that because one of the things I'm most scared of actually

being menopausal is osteoporosis of my spine. I wouldn't like an osteoprotic hip fracture, but it's my spine. And I think people underestimate the importance of the spine until there's a problem. And they're really painful, like you say, those fractures. Sometimes they can be repaired, but not always. But the other thing is that our hormones can modulate the pain receptors as well. You know, they actually stimulate the opioid receptors. So a lot of people will have heard of opioid drugs such as morphine,

but actually our estradiol, progesterone and testosterone can modulate pain in beneficial ways, which a lot of people don't realize, but also reduce inflammation. And like you say correctly, to strengthen the bones, so reducing the incidence of osteoporotic fractures of the spine. Right. So, yeah, I think from the osteoporotic fractures, I mean, that's something obviously, you know, women do tend to a lot significantly higher incidence, particularly later in life when compared with men, you know, And a lot of times, you know, what we see particularly now in patients who aren't necessarily on hormonal replacement and stuff like that is that they tend to come back with more of these fractures. And, you know, they do get harder and harder to treat. They not only cause pain, but they can affect posture, affect balance, effect walking, things like that as well.

So I think definitely in addition to the hormonal side of it, I think kind of keeping track of that, you know, measuring bone density is extremely important. In addition to appropriate training, resistance training and in low degrees, things like that have been shown to have major. positive effects when it comes to preventing those kind of fractures. Absolutely. And your job isn't just the brain. Obviously, you've mentioned the spine, but also the peripheral nerves as well. It's really important because a lot of people get pins and needles and even restless legs. And so people forget actually that the signals from the brain to the nerves and muscles have to be kept firing very quickly so we can be very responsive and reactive.

And I'm very interested in the myelin sheath. So can you explain what the myelin sheath is? Yeah. So the myelin, you know, if you think of a nerve as kind of like a giant wire, you know, and basically you have a cell body. That's what receives the impulses from the outside. And nerves are similar structurally, both in the central nervous system, peripheral nervous system.

What's different is how they're enveloped and how they're protected and the internal milieu. But so you have a cell body that contains basically dendrites, which are little fingers that, get neurotransmitters, which are signals that are sent to other, from other nerves. It's processed within the cell body, and then it's transmitted out through a thing called an axon, which is a giant wire that basically connects to other nerves. So you can have one nerve that supplies a million other nerves that kind of give signals

to the rest of the body. So the myelin sheet is basically kind of an insulation over the axon. And what it's meant to do is to provide increased rate of conduction within the nerve itself. You can think of it as, and so this conduction is called saltatory conduction. Sultory just means it's jumping. So it tends to jump from node to node along the myelin sheet, and that significantly increases the rate in which impulses are transmitted. So understandably, if the mile and sheet is affected, which it can be affected both through hormonal changes, diseases, just multiple sclerosis, things like that, can affect it as well. That slows down to transmission.

And as I was mentioning, you know, if you think of a nerve as a relay station that connects to millions to other relays stations from the body, a damage, even to a small number of degree of the myelin treat can cause catastrophic repercussions when it occurs downstream. They may not just be happening with one muscle, they may be happening with millions of muscle fibers. And that's why, you know, the myelination is important. And as you mentioned, the hormonal changes can play a significant role in that. Yeah, I think it's so interesting. Several years ago now, I was giving a presentation about multiple sclerosis and the impact of hormones.

So I went off and read quite a lot of papers. And once I realized the importance, actually, especially of testosterone to really rebuild the myelin sheath and keep it as good and strong and healthy as possible, it then made me think, what I wonder is that why more women than men are likely to have multiple sclerosis, which we know is a condition that can, the myelin sheath can be negatively affected. And actually some studies have shown that men with low testosterone are more likely to have multiple sclerosis. Yeah, that's absolutely true. And the other thing that's really interesting about that is men who have been on anti-androgen treatment have also been shown to have some increased risk of disease like MS. And same actually, interestingly, with meningiomas, too. You know, it's kind of an interesting area because it's, you're right. It as much boils down to the testosterone as it does to the estuarine.

It's a balance, you know, and it's a very, very delicate balance that when it gets disrupted, you know, can have significant fuel effects downstream. It's so interesting because, you know, any condition that happens more commonly in women in the late 40s, got to be thinking about hormones. But a lot of women who are younger have low testosterone, you know, in their 30s and 40s and they're still not thought about unless it's thought about in conjunction with estrogen and progesterone. So I feel very strongly we have to be thinking about these hormones separately because they have different functions and roles in the brain and the body. They work together, of course, but then they work with other hormones as well. You know, like you say, you've already said, glucose for insulin and thyroxin, for example.

But there's so much we don't know, but we just need to know, don't we? Because if anything we can do to improve our brain function is key. Sure. And yeah, I think those are extremely important points. I think the other one point I really want to emphasize. We've talked so much about symptomatology, relate to hormones, about brain structure, about brain chemistry. And, you know, because social media has a tendency to kind of promulgate kind of myths. The important thing to keep in mind is things like intelligence are not affected by

by these changes. You know what I mean? I mean, the symptomatology can be bad. Those are areas we can treat. But it's important to note that even at the perimenopausal ages in terms of being able to function in a job capacity or anything like that, there's really, you know, there's really no reason why you can't be able to do that just because of these changes. These are symptoms that can be treated. But in terms of overall IQ, intelligence, stuff like that, there's no reason to think that, you know, that women going through those changes have any decrease compared to their male counterparts. Yeah, I think when they're untreated, though, I know hand on her, I wouldn't be working as a doctor if I didn't take hormones. And in fact, I changed. I used, I've been on testosterone for about 10 years and I use a cream.

But recently I changed to the gel just because it's a slightly cheaper and I thought, oh, I'll just try it and see. And I could tell when I rubbed it on, it was floating off my skin. And it only took her about three or four days where I was just a shell of myself. And my husband was like, you just don't seem to be listening. going on, you can't. And it's really quite scary, actually. And I also get migraines as well. And if my hormone levels aren't at the right balance, the migraines are so intense and so severe, and that really affects the way that I not just think that I slam my speech. I can't, you know, function at all. What do you think the reason between the cream and a gel in terms of,

so do you think in terms of absorption, it's not as good? Or what is that? It's all absorption. You know, we use the estradiol and the testosterone. transferring through the skin because then there's no clock risk, it goes straight in, we can tailor the dose. But it's the absorption and people's skin type is very, very different. You know, it can be skin temperature, skin thickness. There's all sorts of things, but some people absorb better than others. And we've published some data to show about a quarter of our follow-up patients need higher than licensed doses just to get adequate penetration through the skin. And we see it a lot. I'm one of those people that just, I don't know, I've got the skin of a rhino. It just doesn't really

it's all very well. And, you know, we can measure levels to make sure that the levels aren't high. It's not we're having high amounts in our bodies. It's just to try and get it through the skin. But having the right dose is really important because we know also that studies have shown that if the eustodal level is low in the body, then there's more inflammation in the body. And there's increasing evidence. Isn't there about neuroinflammation?

So inflammation in the brain being associated with all sorts of conditions. including psychiatric conditions. So we want to be, you know, our inflammation in our bodies and brains needs to be as low as possible, really, for longevity reasons. Yeah. And, you know, as we know more and more about it, a lot of those neurotransmitters we talked about earlier, too, things like dopamine and stuff like that have been shown to have very critical importance in terms of the pleasure, pain responses and things like that.

So given that we know that these factors are related to the hormones we mentioned earlier, likely it has a very important effect, not only on inflammation, but in terms of our perception of the inflammation as well and how we respond to it. Yeah, it's crucially important that we look after our brains. And obviously, hormones are important, but, you know, what we eat, how we exercise, whether we drink or smoke, or drink alcohol, rather, and smoke. All these things can really affect our brain function, can't they? Yeah, so lifestyle changes.

I think that's a very important point, that, you know, lifestyle, I wouldn't say changes, but lifestyle in general plays a significant role. We talked about things like resistors training. You know, one area I was curious is whether with testosterone supplementation, we're talking about whether you see an increase in muscle mass, mass in women when they're getting that, because that obviously is a critical area in terms of functionality. A few other things, diet, Mediterranean diet, you know,

in terms of all-cause mortality, has been shown to be decreased, kind of focusing, you know, less unprocessed foods and olive oil, things like that. You know, I think decrease in alcohol, tobacco consumption, or critical factors as well. I think particularly staying on top of bone density, we talked about that earlier, you know, particularly in postmenopausal women are, is very critical as well. Really interesting. Yeah. I mean, with testosterone, because we're using the natural body identical testosterone, muscle mass really only increases when people exercise. You know, the synthetic testosterone is quite different. You can get, it's an antibiotic steroid, whereas natural testosterone isn't to the same extent. But a lot of people find that they can exercise better. You know, maybe they've got less muscle and joint pain. They've got more. more stamina, they've got less fatigue, but it's easier to build muscle, but not to a ridiculous way. But we know our muscles are metabolically active as well, aren't they? So if we've got better

muscle function, it's not just the strength. It's actually they function better and that can improve the way our whole body and brain work. Exactly. And I think the core muscles, particularly when it comes to the spine, the core muscles, the perispinous muscles, extremely critical in terms of balance, in terms of what you call sagittal balance, just you're really to stand upright. And we know as we get older, you know, with arthritis, with degeneration, men and women, but more pronounced in women because of these fractures and stuff that we discussed earlier, that's extremely important in terms of minimizing stress and other parts of the bodies, the hips, the pelvis, the femur, things like that. And so I think that type of strengthening, you know, it doesn't necessarily have to be

going to the gym and doing deadlifts, but it's in terms of core strengthening, posture strengthening, yoga, Pilates, things like that, swimming even, swimming is very good, low impact activity. Those can significantly decrease bill core muscle strength, improve posture, and improve, decrease the long-term effects of some of these changes when it comes to the spine. There's lots we need to do. I'm very great for your time. But before I finish, I always ask for three take-home tips. As a neurosurgeon, with all your experience of the brain,

what are the three things that anybody listening can do to really look after their brain for as long as possible? Number one, never ignore your symptoms, as we mentioned earlier, any kind of new symptoms changes. There's no such thing as, I think we have not, but both agree, there's no such thing as a stupid question when you see your things. position. Always pay attention to that. Number two, lifestyle and brain health are integrally related. Your brain is controls every aspect of your life. So things like diet, exercise are extremely important and play extremely important role in terms of the overall health of the brain and the nerves in general. And number three, you know, I think the crux of here is that hormonal levels do change, particularly in women after time. I think these symptoms

are expected as you get older. So don't be ashamed to talk to your doctor about hormone replacement, about other options that are available to, particularly when you get to that age if you're having symptoms related to menopause and other things. Lovely. Thank you so much for sharing your knowledge today. It's been great.

Thank you very much. Thanks for having me.