The Mel Robbins Podcast - The Ultimate Guide to the Female Brain: Neuroscientist Reveals How to Boost Mood, Energy, & Focus

Episode Date: June 26, 2025

This episode will change how you understand your brain – and yourself. If you’ve ever felt like your brain is working against you – think brain fog, mood swings, and exhaustion – you’re not... crazy, you’re not broken, and it’s not your fault. Today, world-renowned neuroscientist Dr. Sarah McKay joins Mel for a groundbreaking conversation that will completely transform how you understand your brain. Dr. McKay has spent 30 years studying the brain. She holds a Doctorate in neuroscience from Oxford University and flew over 10,000 miles from Australia to sit down with Mel for this conversation. In this episode, she reveals the 3 factors that influence how your brain develops. She also  tells you how you can use that information to reset your brain for a better mood, more energy, and greater mental clarity. Whether you’re a woman looking for answers about why your brain is freaking out during PMS, or you are forgetting things during pregnancy or menopause, this is a must listen. In this episode, you’ll learn: -The 3 forces that shape your brain before you're even born and how they differ if you are male or female -What’s actually happening in your brain during PMS, pregnancy, and menopause and why it’s not what you think -What men need to know about the female brain and what it reveals about their own -The long-term impact of telling a young girl she’s “not a math person” -Why your brain shrinks during pregnancy and how that helps your baby -The real role of hormones in memory, mood, and mental health What you’ll learn today will give you a deeper, research-backed understanding of how the brain really works, and how powerful it truly is. This isn’t about fixing your brain. It’s about understanding it and learning how to work with it. For more resources, click here for the podcast episode page. If you liked the episode, check out this one next: The Body Reset: How Women Should Eat & Exercise for Health, Fat Loss, & EnergyConnect with Mel:  Get Mel’s #1 bestselling book, The Let Them TheoryWatch the episodes on YouTubeFollow Mel on Instagram The Mel Robbins Podcast InstagramMel's TikTok Sign up for Mel’s personal letter Subscribe to SiriusXM Podcasts+ to listen to new episodes ad-freeDisclaimer

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Starting point is 00:00:00 Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. I am so glad you're here today because everything you think you know about your brain is about to change. After listening to this episode, your brain will not be the same. You're about to learn the truth about how the female brain works from one of the most respected neuroscientists in the world. And if you're a man listening, great. I am thrilled that you're here because what you're going to learn today will help you better understand the women in your life and how to support them in a way that no one has ever taught you. And by the way, you're going to learn a lot about your brain too, because
Starting point is 00:00:44 our expert today is going to tell you that brains structurally work the same way. But it turns out that there are three factors that shape the male versus the female brain. And what she's about to share with you is going to blow your mind. If you've been told for years that your brain is just too emotional or too sensitive, or you're just being hormonal, that you're forgetful, disorganized, anxious, or somehow it's your fault? It's not. Your brain is not broken. It's brilliant. You've just never been taught how it works or how
Starting point is 00:01:17 to work with it. That changes today. This is not about fixing your brain. This is about understanding it and learning how to unlock its full power. Hey, it's your friend Mel and welcome to the Mel Robbins podcast. I am so excited that you're here. I am excited to be here with you and to learn together. It's always an honor to be with you and to spend time together.
Starting point is 00:01:50 But today's episode, holy cow, is this gonna be a good one. And if you're a new to the podcast, I just wanted to personally welcome you to the Mel Robbins podcast family. I am so glad that you're here. Because you made the time to listen to this particular episode, here's what I know about you.
Starting point is 00:02:08 You're the kind of person who not only values your time, you also value your mind. And today, you're going to learn how to unlock the power of your mind from a neuroscientist who has been studying the brain for over 30 years. And if you're here right now because somebody shared this episode with you, well, that's pretty cool. I wanna point out that you have people in your life who care about you,
Starting point is 00:02:31 and they want you to understand the truth and the science about how your brain works and how to work with it. Or they may have sent this to you to validate some of the experiences that you've had or that you may be dealing with now, and to give you some tangible things that you could change in order to make your life better from one of the leading neuroscientists in the world.
Starting point is 00:02:51 Isn't that pretty cool? So thanks for hitting play. Dr. Sarah McKay is a brilliant neuroscientist and author who has flown over 10,000 miles all the way from Australia to be here in our Boston studios for one reason. She's here for you. Dr. McKay has spent 30 years studying the brain with a specific focus on how three factors impact the development of the female brain and the male brain. She got her Master's of Science and Doctorate in Neuroscience at the University of Oxford, which is the number one ranked university in the world.
Starting point is 00:03:26 Mm-hmm, the entire world. Dr. McKay is an expert in how the female brain works in every stage of life, from utero to puberty, periods, sex, pregnancy, menopause, hormone replacement therapy, and dementia. We are gonna walk through every single one of these stages. You're going to learn what's happening in the female brain during each and every one of those stages today. And if you're a guy who's listening, I'm so thrilled you're here because you're going
Starting point is 00:03:55 to learn a lot about your brain too. Dr. McKay is the author of three bestselling books on brain health, including the Women's Brain Book. And here's what she's gonna tell you. Your brain is not broken. It is powerful beyond what you can believe. It is adaptable. In fact, it's always adapting. And once you understand this and you understand the three factors
Starting point is 00:04:19 she's going to teach you about that you need to know that impact how your brain adapts, you're never going to look at yourself or what's possible the same way again. So please help me welcome Dr. McKay to the Mel Robbins podcast. Dr. Sarah McKay, thank you, thank you, thank you for jumping on a plane, flying 10,000 miles to be here in our Boston studios. I'm so excited to meet you, to learn from you. Thank you. Thank you for the invite. I'm so excited to be here in our Boston studios. I'm so excited to meet you, to learn from you. Thank you. Thank you for the invite. I'm so excited to be here. Well, we have so much to
Starting point is 00:04:51 learn from you. Now you have been a neuroscientist for 30 years. You have written three books about the female brain. You speak and teach about the female brain to audiences around the world. Could you speak to the person who is with us right now and share with them how might life be different if they take everything that you're about to teach us today to heart and they apply it to their own life? I would like them to know that their brains are not broken. There's a real focus, it seems, on things like brain fog and baby brain and burnout and we're forgetful. And there's always a focus on what goes wrong.
Starting point is 00:05:35 But when we think about the course of our lives and what neuroscience is actually showing us, it's teaching us that our brains aren't broken. They're adaptable and resilient. And that's the main message. Is it fair to say, just for the person listening, that when you talk about male, female brain, you're talking from neuroscience and a biology standpoint?
Starting point is 00:05:54 Yeah, that's what I'm talking about here. We're not having a conversation about gender? No. Okay. Yeah, and we can talk about gendered experiences, the experiences of being a person in the world who is a girl, who is a boy, or perhaps the identity that you have.
Starting point is 00:06:09 But typically we're neuroscience is focused as looking at kind of, as looking at brain biology. Dr. McKay, I want to give you some of the common things people say about the female brain. And can you tell us if these are fact or fiction? Okay. Is it true that female brains are, quote, wired for emotion and that the male brain is more logical?
Starting point is 00:06:29 False, false, false. False that there's a male brain that's wired like this and a female brain that's wired like that. I mean, men feel emotions and I'm quite logical. I'm sure you are too, Mel. So, false. And that female brains are wired for intuition and the mother instinct. Is that a thing that we're hardwired for? I think intuition is a human phenomenon. It's not male or female. And that's really based on experience and wisdom.
Starting point is 00:07:02 And that's not the sex-based difference. How about women make rash decisions? We're very emotional decision makers. That's really feeding into that stereotypical myth that because women have a menstrual cycle or our hormones change and fluctuate, that that's kind of what's driving us, and I don't think that's the case.
Starting point is 00:07:22 I mean, I feel like quite a logical rational being. I feel the same way but I can get really pissed off and emotional too. Yeah but I mean you know I think all males can too. I think perhaps we've been socialized perhaps to express those in different ways but the idea that women are so emotional and irrational and that somehow emerges from our female pink brains from Venus is just false. Let's talk about math. Yeah, I think math or maths, as I say, I had the S on. This is one of these stereotypes which is pervasive.
Starting point is 00:07:57 It's all around the world. It starts quite young and it extends right through this idea that males are more brilliant. It's this real stereotype and males are also very confident about their brilliance or their apparent brilliance versus women who are a whole lot more humble and I think even this idea that boys are brilliant and girls are perhaps less brilliant but they're hard working really young. And so this is another piece of research that I always like to discuss. It came from a research group in New York, and we can put it in the show notes.
Starting point is 00:08:31 So the researchers went in and they were looking at children in those first few years of elementary school. So they went in and talked to kids who are about five and six and said, hey, who do you think out of these two people and these images here are gonna grow up are super smart? There's a picture of a male and a picture of a female. And they ask them what the five and six year olds
Starting point is 00:08:50 and the girls pick the woman and the boys pick the man. Right. And then they say, who wants to play the game for super smart children? And all of the girls put their hands up and say me and all the boys put their hands up and say me. Then they go back a couple of years later and the kids are seven and eight. And they say, who of these people is smart, the man or the woman?
Starting point is 00:09:09 And all the boys go the man and all the girls go the man. And then they say who wants to play the game for the super smart kids? And all the boys go me. Some of the girls still go me. But lots of the girls go oh that's a game for the boys because the boys are the smart brilliant ones. And that starts to emerge. And they've gone and they've looked at this in different parts of the world. That kind of by about ages seven,
Starting point is 00:09:33 boys think that they're brilliant, and the girls have started to recognize, well, it's the boys that are brilliant. Being clever and good at maths is a boy thing. So how do you explain that as a neuroscientist? Is that because of the images you see in the media and the people that are in elected office and just the world reflecting back to you and so subconsciously your brain is recognizing a pattern and it starts to go, oh, people who look like that do things like this.
Starting point is 00:10:04 I look like this, which means I don't do things like that. Is that kind of what's happening? I think it's all of the things. It's it's everything from TV to books to even the way we talk about it. And I think we can be incredibly well intentioned as well and perhaps give a bit of implicit messaging. And there's some phrases I think people use and I always try and pull them up on it. They might go
Starting point is 00:10:28 Oh well girls can do maths too or girls are just as good at maths as boys and that's kind of implying that boys are the reference point and then girls can also do that or boys are the maths people but girls can be maths people too. So I think we not we almost need to be really careful about the implicit messaging we're inadvertently sending little girls by saying girls can too. Perhaps we should be saying there is no difference in ability to do maths between boys and girls.
Starting point is 00:10:57 Start talking about what the science actually shows. Is that what the science shows? There's no difference between a boy or a girl's ability to do maths. If we got any boy and any girl, just randomly picked them, we couldn't see differences in math scores. Some studies, some of the time, if we were to look at like 10,000 boys aged nine and 10,000 girls aged nine, there might be a few extra boys scoring right at that sort of the top, top, top, top marks, but like a teeny tiny amount.
Starting point is 00:11:25 And that's perhaps where that gendered stereotype comes from. But what no one's ever saying, although perhaps people might have kind of come across that if we were to do the same perhaps with verbal ability or reading ability, there might be a few girls kind of right at the top there as well. And there's this other crazy study, I believe this was published in the New York Times, where they looked at Google searches and they found there were twice as many Google searches for, is my son a genius, than is my daughter a genius. But people are more likely to search for, is my daughter fat, or is my daughter ugly,
Starting point is 00:11:58 than is my boy. Now, if you dial down though, Dr. McKay, to the neuroscience implications of this, if you're seeing by the age of seven or eight, a belief system and patterns that get reflected back to little boys that say, you're smarter or you're this, and then the pattern that gets reflected back to the female brain, referring to the experience and the development of a brain inside the little girl's body. How does that messaging change the wiring and the firing and the connections that happen in the brain?
Starting point is 00:12:39 Do you see what I mean? Because the beliefs and the patterning start to create patterns of beliefs and behavior that then lock in and change the development of your brain. Yeah. I mean, you've said it. That's precisely what happens. And once children start to believe something about themselves, then they will choose to opt in or opt out of certain activities and behaviors or perhaps not try.
Starting point is 00:13:00 We do start to see little girls start opting out. I used to do some work on one of my, I've got two sons who are now teenagers when they're at primary school, I used to go and help out in their classroom. And I remember one little girl asking me what I did as a job. And I said, I'm a scientist. She says, oh, well, I really love dolphins,
Starting point is 00:13:16 but I can't be a scientist because I'm no good at maths. And I was like, oh, I nearly cried. I was like, we need to sort of stop these messages because as soon as you start believing about that yourself, even when you're a tiny child, you're going to start opting out and you're not going to have the enriched experiences, which is what a little brain needs. And we see this all around the world and we see this permeating all the way through the lifespan. That is amazing. And so I think it's really important that as you're listening, that you actually take
Starting point is 00:13:47 away there is no difference. Boys and girls are both good at math. They're both capable of being good at math. They're both capable of developing the skill of math. But this is an important thing to hover on because what you're pointing to is that the messaging and your life experiences start to shape the way that your brain wires up and the beliefs that you have, which then impact how you move through the world.
Starting point is 00:14:13 I want to back up and ask you a question because I'm just curious. If you open up somebody's head and you take a brain out, would you be able to tell whether it was male or female? No, just by looking at that, if you were blinded to the human that you took it out of, and a brain surgeon wouldn't be able to open it up and look at it and go, well, that's male and that's female. On average, male brains are maybe like five to 10% larger
Starting point is 00:14:41 than female brains, but part of that is accounted for by body size and skull size. That brain is kind of driving a bigger body around the world. But even then, you're not going to be able to look at a single brain and go, that's male or that's female. The reason why I'm asking this question is because I think already what I'm realizing is the mistake that you make when you hear female and male brain is thinking that structurally,
Starting point is 00:15:03 the brain itself is completely different. And what you're here to say is no, but because of neuroscience and because of neuroplasticity, the brain is constantly changing, adapting, and rewiring. And so when you say the word female brain, you're basically saying that the female brain adapts and changes differently than the male brain based on the fact that the experience of being female and the hormones that you have and the way that your body changes impacts the development of the brain. Is that what you're basically saying? And is that the right way to think about it?
Starting point is 00:15:41 Yeah, that's one way to think about it. Another way I think about it is often we think that biological sex is the biggest difference between two people, right? So I've got this study I can tell you about that I think kind of helps explain what I'm trying to say here. So this study was published in 2023, and they had nearly 8,000 MRI scans of healthy young humans who are like in their 20s and 30s and an MRI scans when you put a Human in their brain in a brain scanner and you'd like kind of take a photo of the brain structure
Starting point is 00:16:12 Okay And then they gathered them from 29 different countries in the world and then they ranked those countries based on gender Equality, so they looked at things like access to education or work opportunities, etc. And so countries that would score really high in gender equality would be like the Scandinavian countries like say, you know, Denmark and Sweden, and countries that scored lower in this study were places like Brazil and Turkey and India. And it turned out when they compared male and female brains in these countries with more equality, the brains were more similar. In countries with greater gender inequality, male and female brains
Starting point is 00:16:50 were more different. And the male brains everywhere were the same. It was the women's brains, the female brains in countries with gender inequality, that were more different. And so the researchers think it was something to do with access to education and the stress of the whole living in this kind of society with structural sexism, et cetera. So we've got biological sex there determining this particular metric that they measured in the MRI scan,
Starting point is 00:17:18 but you've also got the gendered experiences of people living in those countries. Dr. McKay, based on the study, I just want to try to give something back to you to see if I'm interpreting what you just shared correctly. What that study suggests, especially given that the male brains didn't change a lot, but the female brains did based on the inequity, the stress, the access to education, the messaging to women in various parts of the world, that the differences that emerge between the male brain and the female brain have a lot to do with the external factors and social conditioning and the stress and
Starting point is 00:18:03 trauma and whatever else that the human being with the brain is experiencing? I couldn't have said it better. What are some of the things that really impact the development of the female brain and the experience of the female brain that maybe a lot of people don't even stop and consider are impacting brain development. I think this study in particular, the researchers are very careful, because we're scientists,
Starting point is 00:18:30 we always like to be very careful to say they couldn't tell exactly what to attribute those differences to. But one overarching idea that we often talk about in this field is the idea of enriched experiences or enriched environments. So this is living somewhere obviously safe, where they can explore, when children can be educated, when there are opportunities to be able to sort of explore the environment and learn and be shaped by it. And it seems that in the case
Starting point is 00:19:06 where there is greater gender inequality, the little girls in those parts of the world don't have as many enriched opportunities as the little boys do. That makes a lot of sense. It makes a lot of sense because, you know, I remember Gabor Mati was on the show and he was talking about health outcomes for women
Starting point is 00:19:26 and was pointing to the rise in autoimmune diseases that are impacting women. And basic said, obviously there's biological factors, there's factors where people are more predisposed from a gene perspective, but that it is irrefutable that women experience more stress. They're the victims of more violence. They experience more trauma and in parts of the world are also discriminated against. And that those adverse life experiences, which are not your fault, certainly impact your immune system. It impacts your nervous system, which in your research certainly also has an impact on the brain that the brain develops. And so that's just super helpful to kind of have as a backdrop only because when you talk
Starting point is 00:20:16 about the male and female brain, a dummy like me is like, oh, she's talking about the difference between the male and the female brain in this drug. There must be different. Like a woman has a vagina, a man has a penis. They're different. You're basically saying, no, the experience of being is different, and that can have an impact on the way things develop. So you've developed this three-part framework that can really help us better understand the brain and how it works and how it's programmed and what impacts it can you walk us through that?
Starting point is 00:20:49 Well, it's inspired by the biopsychosocial framework, which is a really boring way to talk about things. So I like to talk about biology as being the bottom up. So our brain is receiving information from our bottom up body. So that is everything from our hormones to the food we've eaten to muscle tension to sensations we can feel in our body
Starting point is 00:21:11 to all of the signals that we wouldn't have. You wouldn't have a clue what your gut pH is at any moment in time. So your brain is receiving all of that data. Data is also streaming in from the outside world through our senses, through what we see, what we hear. And if something's close enough to us, we could smell it or taste it or touch it. And that includes everything from the rising and setting of the sun to other people and
Starting point is 00:21:34 our interactions with them, to our lived environments, to what is streaming in on that phone that we're holding in our hand. And that's become a really big outside influence within the last decade or two. And the brain is then making meaning of what's happening in our body in the context of the outside world. But we've also got what I call top down.
Starting point is 00:21:56 And that could be our thoughts, our expectations, our past experiences, all of which is kind of mixing up with the bottom up, the outside in and the top down. And each of these factors can influence others. So we know that perhaps an outside in influence could shape a top down experience. So perhaps loneliness could shape the experience of depression. Or we know that something bottom-up can shape something going on in our brain. So we know during pregnancy,
Starting point is 00:22:31 for example, the hormones during pregnancy shape and sculpt our brain so that we interact with the outside in a baby in a particular way. So that's just how I like to simplify the complexity of all of the information that the brain is making meaning of at any one moment in time. Let me see if I can give that back to you. So you have a three-part framework and the first one was bottom-up, which basically the way I would put it is every single physical input data point that is happening in your body is messaging up to the brain. And that's one thing that shapes your brain. It's one thing that impacts your brain. Second thing is you're getting flooded from the outside world through your senses, all kind of,
Starting point is 00:23:19 from the headlines to people's moods, to all that stuff. And all of that actually also is input into your brain that changes and shapes your brain, how it functions, all of it. And then you said top down, which is the thoughts, the messaging, the things that you're thinking about that you're trying to make sense of is also impacting. And you're talking about like the physical structure, the neuro connections, like all of that.
Starting point is 00:23:46 And the brain is kind of processing all of that information and then going, well, what should I do next? Hmm. Well, what I love about this, because it's very encouraging and empowering, is that if all of these three inputs, the physical body, the outside world, the things that you say to yourself
Starting point is 00:24:03 are actively shaping your brain, then if you get more intentional about all three of those things, then you can actively shape your brain in a positive way, particularly if you understand the developmental cycle that your brain is in and sort of the objective that it's trying to achieve. I would love to take a moment and really understand how the brain continues to develop throughout a woman's life. So let's start at the beginning. Were there any other differences in terms of the way the brain develops
Starting point is 00:24:35 between a baby boy and a baby girl? Not really. Typically when we're looking at that developmental trajectory of the brain from kind of birth through to puberty, little children's brains kind of develop along a pretty predictable trajectory. And there will be more differences in how, you know, children are raised or their life experiences they have,
Starting point is 00:24:58 or heaven forbid adverse experiences they have, but then there would be between males and females. And so during that sort of first year of life, there's this explosive brain growth. We've got new neurons being born, which are a type of brain cell. And the development in that first year of life is five times faster than the next five years. That preschool development is faster than the entire rest of your life. So by the time you start school, your brain is at like an 80 to 90%
Starting point is 00:25:28 of where it will be for the entire rest of its life. Wait, hold on a second. By the time you're in preschool. You're at primary school, elementary school, you would say. So by the time you're about five, your brain contains almost all of the neurons that we'll ever have. And what you start to see from then on is the connections between the neurons, or synapses,
Starting point is 00:25:49 we call them. We start to sort of see them forming circuits, making connections, pruning and tuning. And most of the development we see through sort of mid and late childhood up to puberty is not so much adding new neurons and getting bigger and bigger, but kind of refining the connections
Starting point is 00:26:08 and streamlining the circuits in the brain so the brain can kind of get on with the business of learning how to be a little human. That is so fascinating. Dr. McKay, let's take a quick pause because what you're saying is blowing my mind. I'm sure as you're listening to Dr. McKay today, it's blowing your mind too. I can think of seven people I want to send this to right now.
Starting point is 00:26:31 And so I'm going to give you a chance to share this episode with people that you care about. I'm going to do the same while we listen to our amazing sponsors. Do not go anywhere, because when we come back, you're going to hear more from the amazing Dr. Sarah McKay, including the one thing that will do the most to improve your brain health, whether you have a female brain or a male brain, and the crazy explanation of what's happening inside a female brain when you're having a hot flash.
Starting point is 00:26:59 Stay with me. You don't want to miss us. Welcome back. It's your buddy Mel Robbins. And today you and I are learning from the super smart and great at math, Dr. Sarah McKay. Dr. McKay, let's get back into it. After kind of the primary school, when we get into puberty, what is going on in our brains when puberty hits and why does it feel so crazy, intense and confusing? Yeah. So I always like to say brains go through puberty too.
Starting point is 00:27:42 Oh, I love that. Yeah. Cause we think about it as being something that our body does. Yeah. But our brains are going through puberty too. So let's just focus on female puberty. But male puberty happens too. And in fact, male and female brains
Starting point is 00:27:59 follow a similar trajectory, but kind of almost kick-started by sex hormones. So it doesn't matter whether it's the estrogen in the girls' brains or the testosterone in the boys' brains. They kind of follow a similar trajectory. In fact, just to kind of clarify that, we often, you might have heard this idea that girls' brains are more mature than boys' brains when they're going through the teenage years.
Starting point is 00:28:25 But that's because girls on average tend to go through puberty about a year or so earlier than boys. And what we know is that brains are more likely to track along pubertal stage than chronological age. Oh. Yeah. Because you think about, you know, all of the kids that you've ever known when they start going through puberty, and you've ever known when they start going through
Starting point is 00:28:45 puberty and you could get a boy who's going through puberty quite young, like perhaps you know he's six foot tall, his voice has dropped and he's got hair everywhere and he's 12. Whereas you could have a little girl who's 16 who hasn't started her periods yet. Well his brain would perhaps be at a later stage of development than hers would be. That's so cool. Yeah, but we typically think that girls' brains are more developed than boys,
Starting point is 00:29:08 but that's just because on average, girls have puberty a year, a year earlier. No wonder middle school is so confusing because you basically may be sitting next to somebody who's got like a 19-year-old brain, but you yourself have like the 12-year-old pubertal stage in your brain. Wow, that makes a lot of sense.
Starting point is 00:29:26 Yeah. So there's these, there's sort of like a biological clock sort of switches over in your brain saying, hey, it's time to start puberty. And then that sends a message down to your ovaries. And then the ovaries sort of start that monthly cycle. It takes a while for ovulation to kind of set in as we're going in through puberty. But then we start to see the ovaries releasing pubertal hormones or sex hormones, primarily estrogen and progesterone. And what
Starting point is 00:29:52 we see in brains then is a lot of the growth that happens during childhood in the brain, particularly the gray matter, which is kind of the wrinkly outer kind of covering of the brain, and also some little subcortical structures, we see that sort of start to refine and streamline. So I said, we've got all of the neurons, all the brain cells that we're ever going to have, but what we see is the connections between them kind of pruning and tuning. So we see the ones that we don't need almost being kind of pruned away, and the ones that we want to be, they kind of become tuned. What ones that we don't need almost being kind of pruned away and the ones that we want to be there, they kind of become tuned. What ones do we not need? Well, what determines what ones stay and what ones go are the experiences that we have.
Starting point is 00:30:34 So the brain kind of goes into this sort of new phase of sensitivity to experiences. Really? Yeah, very similar to what we see when a little child's learning to talk. So their language centers of their brain go into this critical period and those little people will seek out experiences of language. They're constantly pointing and asking why and wanting to get your attention. They're constantly wanting you to converse with them because the language centers in their brain need conversation to wire up. When you're going through puberty and adolescence, a large part of that reorganization and pruning
Starting point is 00:31:10 and tuning is in the social brain. And that's when we start to see those parts of the brain reorganize and shape. And what is kind of required, I think fundamentally, to go from the family nest out into the world and build a new tribe of your own is courage. And one thing that we see is the flip side of courage is bravado. So we've also got layered on top of all of the, the social brain development. We've also got a lot of sensation seeking, like wanting to kind of go out and have all of these experiences because that's kind of what courage to leave the family nest is kind of resulting in as well.
Starting point is 00:31:50 It's like I need to go out and I need to try all these new things, and I need to have these experiences, and I need to do all of these things with all of these different people. Because the brain requires all of that to one, rewire and reorganise to become an adult, but two, to be brave enough to become an adult. This is so cool because basically the brain has all of this programming ready to come online. And it's the hormones during puberty that are like, all right, it's co-time. You hate your parents, your friends are important. you need a significant other, your town that you grew up in sucks and it's time to go explore the world.
Starting point is 00:32:28 You hate everybody and everything. You think you know it all. Yes. That's basically the wiring in the brain. 100%. 100%. And is there a difference between the way that puberty for the male brain brings that online or the way that boys tend to respond to that change
Starting point is 00:32:47 versus the way that the puberty hormones and all of that coming up and lighting up in the brain is different for girls. I mean, we do start to see some of the sex differences that we see in adulthood do start to emerge around puberty. And we can talk a little bit about perhaps mental health in a moment. But in terms of that developmental trajectory
Starting point is 00:33:09 from a child's brain to an adult's brain, we all go through that. But the experiences that we're kind of seeking out, the same types of experiences and often they're with each other, of course, we see these behaviors sometimes play out differently. And part of that may be, particularly in young males, testosterone does drive a tendency
Starting point is 00:33:33 towards some types of behaviors. That sensation seeking in particular, which looks to adults like really dumb decision making or risky behavior, girls might be less likely to do the same kinds of reckless activities, but there are some things that girls can do that might not necessarily be to their benefit. We might need to encourage them a little bit more, even if it's just to do something that might feel to them risky,
Starting point is 00:33:57 like, I don't know, putting your hand up in the classroom and asking a crazy question. You know, there's different types of risks that people take depending on what kind of peer approval they're going to be getting. So it's very hard to separate out the risk-taking behavior there from that social aspect of peer approval. What I find fascinating is just that this is all in the brain ready to activate. And you can get very frustrated if you're a parent or if you're the older sibling.
Starting point is 00:34:29 And we roll our eyes at those years without this recognition that actually this is part of what the brain goes through that is developmentally accurate and normal for somebody that age. And you and I are gonna to dig deeper into this topic of the female brain because your insights, Dr. McKay, are incredible.
Starting point is 00:34:51 So give me a second. I want to pick my job off the floor. I want to have this kind of marinate. This is kind of that top down thing you were talking about. And let's take a break. When we come back, you and I are digging into PMS. So stay with us. And while you're listening to our amazing sponsors, make sure you share this with everybody in your life. The women
Starting point is 00:35:12 in your life need to understand the science of the female brain. The men in your life need to understand the science of the female brain so that they can understand and support you. We all need to understand this. So don't go anywhere. Dr. McKay and I will be waiting for you after this short break. Welcome back. It's your buddy Mel Robbins. And today you and I are learning all about the female brain
Starting point is 00:35:43 and the three factors that shape the brain and the brain development with Dr. Sarah McKay. So Dr. McKay, let's keep going. Why are teenage girls more prone to anxiety and depression? All through childhood, if we were to have diagnosed anxiety and depression, boys and girls are pretty similar. And we do start to see a divergence of puberty.
Starting point is 00:36:03 Boys, of course, can experience anxiety. And of course, experience depression. But we do see a higher incidence in girls. And I think then the next question to ask is, well, what causes something like depression? Or what causes something like anxiety? And I always say depression comes in many shades of blue. And there's as many shades of blue
Starting point is 00:36:24 as there are causes of those shades of blue. And this is when I like to get back to my basic model of we've got this brain sort of sitting in a universe, right? It's sitting in our body. So there's all of this information that it's receiving from our body, you know, everything from hormones. And we tend to just blame the hormones, but there's a lot going on in our biological bodies that we can do to take care of our brains, sleep, exercise, food, all of the things that we as mothers tell us to do. So we've got a bottom-up biology,
Starting point is 00:36:59 which we could tweak and shape and shift to influence depression outcomes. We've got a lot of outside influences, you know, education, family, do you have stable loving relationships? So we've got all of that in the outside world. And if we, you know, we're breaking friendships, or we're lonely, or we're stressed by social media, you know, our brain is making meaning of that information, the outside in as well as the bottom up. And then we've got top down because we're humans. So we're constantly telling ourselves stories
Starting point is 00:37:29 and making meaning of what's going on. So we've perhaps we're ruminating or perhaps we haven't learned to reframe, you know, into a more healthier way of thinking. And all of these pieces of information from the bottom up, the outside in, the top down, our brain is making meaning of all of these pieces of information, from the bottom up, the outside and the top down, our brain is making meaning of all of them. And there's going to be differences there between boys and girls.
Starting point is 00:37:51 And by meaning, you basically mean the brain is changing the way it's wired, creating new connections, ending old connections, locking in beliefs based on this kind of three-part framework of the bottom up, which is like the physical environment that the body's in, the outside world. And you use the word flooded, which I freaking love because that's how it feels. It comes in through our senses, through our eyes and our ears. Yes. And then the top down, which is the things that you're saying to yourself as you're trying to make sense of all of this, all of which impacts
Starting point is 00:38:25 the way your development operates and develops. And if something's not quite right, and many, many, many, many of those different kind of data inputs, any one of them could influence mood and depression and anxiety. So as I say, there's many shades of blue. So it could be someone's more depressed because maybe a girl is what we might say hormone sensitive. So we like to talk about hormones as being the cause for depression, the cause for anxiety. And that's where we start giving girls that message from puberty and it's really damaging. But we do know that there are some girls and women
Starting point is 00:39:01 who are what we might call hormone sensitive. It's not like they've got bigger highs and lower lows of hormones. It's that there's something about their body which makes them a little bit more sensitive or vulnerable to those shifts. Dr. McKay, I should say that one of the reasons why I'm jumping on this term hormone sensitivity is because in the past, I have absolutely blamed bad period cramps, menopausal symptoms, all kinds of stuff on just being sensitive to hormones. And what I'm learning from you,
Starting point is 00:39:32 and what I've learned as the mother to two daughters in their 20s that have had issues with hormones, is that we reach for the label, but you're teaching us that this is much more complicated than just a label. Because if you think about the three factors, there are things within your control, whether you're talking about, are you eating healthy?
Starting point is 00:39:52 Are you getting sleep? Are you not drinking alcohol? Are you moving your body? Are you connected to positive friends? Look at some of these things in your control. Get a good night's sleep for a couple of weeks. Stop drinking alcohol. Reconnect with your friends. Take better care of yourself and see if you're able to manage
Starting point is 00:40:10 the ups and downs of life and your hormones a little bit better. I love that. And I love that you're making us smarter about the things that we can do. You mentioned sleep. Can you explain? You just kind of casually was like, well, sleep is the number one thing. Why is sleep and getting more sleep other than social connection for the male and female brain? Why is sleep so critical for the female brain? And I think for the brain, for babies, teenagers, everyone, if we miss one night's sleep, everything is harder.
Starting point is 00:40:41 It is so much harder to do all of the other things that we need to do, you know, both on our to-do list, but also to look after ourselves. So we all know how bad we feel after one night's sleep being disrupted. What are the repercussions? Like what's happening when you sleep that's important for your brain health? So there's a whole host of different things that kind of go on. So we know that we, that's when our memories get consolidated during the day, our brains kind of sifting through and reshaping and kind of moving our memories and our experiences and what we've learned and from short-term storage into long-term storage.
Starting point is 00:41:18 And we know that again, poor sleep is a risk factor for poor mental health, for poor brain health, increases your risk for almost every health condition. People who consistently have bad sleep have higher rates of mortality. So, it permeates every aspect of kind of our physiology and our psychology. Makes sense. One of the things that I read in your book
Starting point is 00:41:41 is that a woman gets her period about 450 times in her lifetime, and yet you still don't quite understand how to deal with the fluctuating moods and the brain fog and all the other mental and emotional symptoms of PMS. What is happening in the female brain when you're going through your menstrual cycle? Oh gosh. We could do hours and hours on this one, Mal. So, we have this brain and ovarian conversation that sort of starts at puberty and it goes maybe 450 times through your life, depending on how many pregnancies you have. And if you're on the pill, you can flatline it until menopause in the last couple of years.
Starting point is 00:42:25 There are these epic studies that have been done by women scientists who have started experimenting on themselves. They're like the Marie Curie of neuroscience. And so they are doing all, instead of waiting around for someone else to do the study, they're like, let's just do it on ourselves. So there's a couple of scientists who have said, right, I'm going to put myself in a brain scan every day to see what happens across the course of my menstrual cycle. And they're being very meticulous and very careful in taking blood samples so they know
Starting point is 00:42:54 exactly which day they're on, what the different hormone levels are doing, and then they'll lie on the brain scanner and just lie there for a couple of hours. And what you can do is just look to see how the brain is just reacting when you're lying there doing nothing. So we see as you go into ovulation, when your estrogen kind of peaks, and a couple of days later, because the brain networks take a kind of,
Starting point is 00:43:16 they kind of lag a little bit behind the hormone, because the way the hormone works on the cell is it interacts with your chromosomes and your DNA. It's not like this immediate, like millisecond response takes a couple of days. works on the cell as it interacts with your chromosomes and your DNA. It's not like this immediate millisecond response takes a couple of days. We see that those brain networks become far more integrated and specialized when there's high estrogen and then as estrogen drops off and then progesterone starts to rise in the days before your period, different brain networks sort of start to interact more
Starting point is 00:43:45 with each other. And for some women, that just might feel like, it might feel like nothing. But for other women, it might feel like an absolute emotional roller coaster, right? So the urban flow in everyone is going to be the same. The levels of hormones in everyone are going to be the same. But for some reason, in some people, that can feel like a rollercoaster. Others, it barely feels like a gentle ripple. What happens, what does the pill do to your brain? Like what's happening in your brain?
Starting point is 00:44:14 So the same scientists that have learned in the brain scanner every day over the course of the month, they gave the study a very cute name. They called it 28 and Me. And then they did a study of the oral contraceptive pill and called it 28 and OC, the oral contraceptive. Very epic science that's being done by these women. And then they went on the pill. And so we know that when you go on
Starting point is 00:44:35 the oral contraceptive pill, which is an excellent form of contraception, that it flatlines your natural levels of hormones. And then you kind of get this high level of hormones from the pill and it kind of depends on which formulation that you're taking. Does it hurt your brain? No, it's what we would see if we're looking at these networks is that the networks then flatline. Instead of ebbing and flowing with your natural levels of hormones, your natural levels of hormones are flat, the levels of hormones from the pill are flat and so your brain waves just kind of go flat.
Starting point is 00:45:08 And for some women, that might feel like stable mood. So we know some women go on the pill, and they find it stabilizes their mood, particularly women that have extreme PMS or the extreme form of that PMDD. Some women find that going on the pill makes their hormones, stabilizes their hormones, and makes their emotions feel stable. Other women might feel that maybe their emotions are flattened. Because we've all got very, very different sort of responses and sensitivities to how hormones are interacting
Starting point is 00:45:39 with our brain. And there does appear to be sort of a subset of women who are hormone sensitive. And by hormone sensitive, what exactly do you mean as a neuroscientist? Yeah. So there is, and we don't know, I mean, this, we're still kind of at the very, very early stages of starting to understand what is going on in a brain that's responding to hormones, let alone what is going on in the brains of all these different people who have different types of experiences and different types of emotions. And it's particularly emotions that we're interested in across the course of the
Starting point is 00:46:13 menstrual cycle. So there are plenty of women who will say, yeah, look, I have PMS symptoms, I experience, I feel angry and irritable and grumpy and weepy, etc. before their period. I feel angry and irritable and grumpy and weepy, etc. before their period. There are also a subset of women who might feel particularly energized and maybe even a little bit frisky with the unloading of estrogen, so around ovulation. We've all got these different sorts of, appears to be this different kind of baseline sensitivity to these hormone fluctuations. And it's not that the levels of hormones are any different, there's something in the way that we're responding to those hormones that are changing.
Starting point is 00:46:51 But we don't really kind of know what it is. We do see these hints back to like girls who go through early puberty and perhaps even girls have experienced early childhood trauma. I can't believe you just said that. Because I just wrote down on this piece of paper, I wonder if hormone sensitivity is correlated to adverse childhood experiences or sexual abuse. It is. It is? And that's not inevitable if you experience that you will be hormone sensitive, or if you are hormone sensitive it is only due to that, but we see a tendency. And so there is some clinicians and researchers, particularly those working in the menopause space who are starting to recognize the sensitivity and then kind of going all the way back to
Starting point is 00:47:34 early childhood and asking women, well, you're in perimenopause, you've got depression, or you had postnatal depression, what was your early childhood like? It's not a direct causation in everyone all of the time. It's a risk factor. It is a risk factor. So we're starting to see that kind of emerge. Well, it makes sense because what you're teaching us is that you basically have taught us that you have all neurons in place, right? That 80% of the brain is developed by the age of five. That every experience both in your body
Starting point is 00:48:09 and flooding you from the outside and the way that you process it from the top down fashions the way that the brain is shaped, how it operates, what synapses come on, which ones disconnect. And so if you have adverse experiences and those adverse experiences flood you with hormones or neurochemicals, something is happening with the receptors in your body. And so it would make perfect logical
Starting point is 00:48:39 sense that that would be a risk factor in terms of the way that your body processes those exact same hormones later in life or those neurochemicals. Yep. Yep. I mean it's logical. And it kind of becomes cumulative as well and that's why one researcher I spoke to says puberty is like an emotional blueprint for how we're going to respond to reproductive experiences later in life because it's almost sort of setting that in place. So particularly, I think parents or, you know, caring adults around girls who are early, you know, going through puberty early, we know that we can provide those kind of protective experiences and do the best we can to help those girls go
Starting point is 00:49:17 through that kind of, you know, entering puberty before their friends, that experience kind of helping them through that. And there have been studies done, like kind of looking at those as interventions. And so it's a really it's like a really important time to kind of intervene for one of one of a better way, because we will see, you know, the kind of the repercussions and one of the risk factors for depression at any point in life is have you had a previous experience of depression? How does pregnancy and motherhood change the brain? Oh, one of my favorite topics, Mel. I've written a whole book on this. So an overarching statement I would make would be that pregnancy prepares the brain and mind for motherhood.
Starting point is 00:49:59 And some studies have been done and this was pretty much nothing was published on how women's brains changed during pregnancy and motherhood until sort of around 2017. So it was quite late. We knew what was happening in animals. There was a group in Spain, and again, there's some really great researchers out there working in women's health, and they're all women. And it's because they're all women. And it's because they're the ones asking the questions. So it was back in 2009, these kind of three women were having this conversation and said,
Starting point is 00:50:32 well, what would happen if we became pregnant? Let's go look at the research. There is no research. Let's do the study ourselves. Let's get pregnant and scan our own brains and try and find some friends to join in. And so that has like this field of sort of the maternal brain or the neurobiology of matrescence, you could call it has sort of exploded.
Starting point is 00:50:51 And so they've scanned women's brains before their first pregnancy and after their first pregnancy. And more recently, another epic study done by a woman who's experimented on herself, scanned her brain all the way through pregnancy. And we see this enormous structural reorganization. Really? And rewiring of the brain through the course of a pregnancy.
Starting point is 00:51:10 What happens? Oh my God, you're literally like making another human being. You're making the brain like figuring out how to talk to the mechanics of the baby. Yeah. Yeah. So the biggest, so they see, and this, when I first, the way I, I don't like to say this, because people immediately think that something has gone wrong. But we say we see a 4% volume loss in the brain
Starting point is 00:51:32 during the course of a pregnancy. But we also see this in teenagers' brains and adolescent brains, right? They get slightly thinner as the brain is streamlining and refining and pruning and tuning its synapses. And we see this throughout the brain during the course, particularly of a first pregnancy. And it's primarily in those parts of the brain which are involved in social cognition. So what does that mean?
Starting point is 00:51:53 What does someone else thinking? What is someone else feeling? How do I read the needs of somebody else? And how do I deploy the right behaviors to look after them? Meaning you care more about it? It was the other person that you're going to be looking after at the end of a pregnancy. It's the little baby. Yes. So your brain is being reorganized
Starting point is 00:52:11 to deploy the right types of behaviors to look after your baby. And that sounds very kind of like I'm describing what happens in an animal, but we've got very, a whole lot of data from, you know, many other animals in the mammalian kingdom looking to see how their brains reshape and reorganize so they deploy the right types of maternal behaviors.
Starting point is 00:52:31 Well, if you don't, the baby's going to die. Well, exactly the same thing happens to us. So we become very, very tuned in. Our, you know, this new baby comes into the world and you can't really sort of think about anything else. All of your attention, particularly with your first baby, is solely focused in on that little baby. You almost can't think of anything else.
Starting point is 00:52:50 No wonder you can't remember about the bananas or the keys or your husband's lunch. How horrible the labor was. Yeah. What is happening with your brain where you forget the pain of? I think mother nature has made that a thing so that we just keep on having more babies.
Starting point is 00:53:06 I remember my first childbirth and being really annoyed with my sister because she is one of those people that said it was good pain, it wasn't that bad. And I remember a few hours in when I started screaming for the epidural, she said it was going to be good pain and it's not, it really hurts. She said it was going to be good pain and it's not, it really hurts. And then I remember the first contraction with my second son. I was like, oh, that's right. It's all coming back to me now. Second birth was easier. Actually second, the second time around motherhood is a whole lot easier because your brain has
Starting point is 00:53:41 already gone through that process of reorganizing, reshaping, and then learning how to become a mother. So what happens when the baby's born? Your brain has gone into another sensitive phase of learning by experience because of all of the pregnancy hormones you've experienced. It's a little bit like puberty. And that is why sometimes we talk about matrescence as like adolescence, as this journey of becoming, of becoming a mother. So through pregnancy, your brain is reshaping and reorganizing so you can become a mother. And it makes that learning curve perhaps a little less steep. You still need to figure your baby out and learn how to take care of it, but your brain
Starting point is 00:54:21 is kind of primed to react and respond and almost to focus solely in on that new little baby and take care of it, but your brain is kind of primed to react and respond and almost to focus solely in on that new little baby and take care of it. Is there anything that's happening in the male brain while the female brain is undergoing all this? Yeah, so the woman in Spain, this was the first study that was ever done looking at this, because they were clever and smart women, they said, let's look at the fathers.
Starting point is 00:54:43 So these were heterosexual couples. Let's look at the fathers. So these were heterosexual couples. Let's look at the fathers of these babies as well, scan their brains before and after their partner's pregnancy and look to see if their brains change. And in comparison to the mother's brains, their brains did not change. At all? At all.
Starting point is 00:55:00 However, if you just look just at the males and you kind of increase the, like get more men involved who have just had babies, their partners have just had babies and just scan their brains, we do see some tiny little changes, not at all in comparison to the women, but tiny changes within those men's brains, which are based on how involved they are with childcare. And you know, some men are there for the act of conception only, some fathers, and are never seen again, and other fathers are the primary caregiver.
Starting point is 00:55:32 So you would expect if a dad is the primary caregiver, his brain is going to change a whole lot more than the dad that was just there for conception only. So let's talk about menopause, because I would imagine that- Are we not gonna talk about baby brain and forgetfulness? Oh, sure, I forgot. I'm not even pregnant for crying out loud. Only because that's-
Starting point is 00:55:53 What do you mean? Why is there forgetfulness when you have a baby? Well, lots of people talk about like mommy brain and baby brain and you become forgetful. Because we're exhausted. Well, yeah, well, so four out of five women during pregnancy and early motherhood will say yes. And I didn't experience it, which is why I wanted to write the book, because I thought
Starting point is 00:56:10 I didn't know it was a thing. It wasn't a story I'd ever heard and I didn't experience it. And I was like, I wonder if there's something in that. Is there a neurological thing? Well, we know our brain is completely reorganized to attend and focus on the baby. And memory depends on attention, right? So what information you take in and what you filter out. And so when you're entirely focused in on your new baby, you're not going to
Starting point is 00:56:35 remember all of the other things, but because we have been told that if you've got a female brain, you add some hormones in and you add motherhood to the mix, you're kind of dysfunctional and you're on the decline and you know got a female brain, you add some hormones in, and you add motherhood to the mix, you're kind of dysfunctional and you're on the decline and all of the potential things that can go wrong. And of course, we could experience postnatal depression. Of course, we could experience postnatal anxiety.
Starting point is 00:56:56 But we know from the research that women who are experiencing less overall well-being over that amount of time, have less social support. I mean, no one's getting sleep right. They are much more likely to describe their experience as what we would call baby brain than women who are well socially supported, don't have postnatal depression, are kind of doing okay. So it's not women's brains that are letting them down. It's the social support that they're not receiving to parent that is letting them down.
Starting point is 00:57:30 But we have persisted with this story that there's something neurologically wrong with us when we become mothers. So we shouldn't call it that anymore, right? No, it's not. Because that's actually the wrong term. Because if you call it baby brain, you're basically blaming your brain. And what you're saying is, no, no, no, first of all, your brain's working right because any energy you have, your brain is being ordered to focus on this human being whose survival
Starting point is 00:57:56 is dependent on you. So the fact that you are focused on the caregiving is what you're designed to do. It's working correctly. The problem isn't baby brain. The problem is you're designed to do. It's working correctly. The problem isn't baby brain. The problem is you don't have support. Yeah. And you will have heard of like the emotional labor or the cognitive load of motherhood or just being a woman and having to do all of the things. And people love talking about a super mom, right? Because she can kind of do everything. Give it to her. She can do
Starting point is 00:58:21 it all. And if she drops a ball or something goes wrong, well, it's okay, because she can just blame her baby brain. And then everyone goes, oh, well, it's her brain's fault. Yeah, you can still cook dinner and do the night feeding and I'm going to sleep for 12 hours while you do all that and it's your baby brain. You'll be fine in nine months. It's not her brain.
Starting point is 00:58:39 And we've got this amazing research looking again, like I talked earlier about imaging brain networks, and look at mothers brains and their brains are more flexible and efficient and responsive. But we persist on always telling the dysfunctional story instead of looking at the strengths. What is the best intervention? Is it getting support and sleep? Yeah. The second you start saying I've got baby, no, look where you need support. Yeah.
Starting point is 00:59:06 Well, I mean, it shouldn't have to be up to the mom to like be told to look for support, should it? That's true. That's true. So let's talk about menopause because another period in a woman's life where we tend to talk about brain fog is when we're going through menopause, what is happening to the female brain when we dry up like a raisin?
Starting point is 00:59:32 Well, that brain ovarian conversation that's been going on, we've talked about puberty, we've talked about menstrual cycle, we've talked about pregnancy, it kind of starts to falter a little bit and it's been kind of going on really nicely for many years. And then what happens is menopause actually starts in our ovaries, right? We run out of eggs, ovaries start to give up.
Starting point is 00:59:55 Sometimes they ovulate, sometimes they don't. The brain is up there listening going, you didn't ovulate. Ovulate! The ovaries go, okay, there's huge amounts of estrogen. The brain goes, not that much. The ovaries go, okay, there's huge amounts of estrogen. The brain goes, not that much. The ovaries go, okay, sorry. So you know, we kind of get this rollercoaster and that's what we would call perimenopause. And then our brain is starting to respond to that massive rollercoaster.
Starting point is 01:00:17 We know kind of what happens with our bodies. We get irregular periods, we can get really heavy periods, we can get none. And then they come back and it lasts for two weeks and all of the things that are going on. And our brain is kind of in the middle, trying to adapt and respond and flex and kind of make the most of this sort of situation that it's in. Brain fog is one of the words that we use, this kind of umbrella word that we would use to describe this kind of constellation of symptoms, perhaps not dissimilar to baby brain again, but this time there's probably a little bit more of a biological cause behind it.
Starting point is 01:00:53 But we're not sure exactly what is this kind of nice, neat biological pathway, and I love a biological mechanism. We know that the estrogen's kind of rollercoasteringing and then after menopause it's flatlining. We're pretty sure we know how the brain causes hot flashes and how that estrogen is involved there. How does estrogen cause hot flashes? So we've got the hypothalamus, that part of the brain that's receiving all the data from our body. So it's also, it regulates our body temperature. And the thermostat in the hypothalamus is almost set by estrogen for some reason.
Starting point is 01:01:28 The brain evolved to have that thermostat to be set by estrogen. When the estrogen starts doing its crazy thing, the thermostat gets really narrow. So the top goes, so it gets much narrower. So your body temperature only needs to rise a tiny bit to kind of hit the upper level. And your brain goes, it's hot in here, it's hot in here. And it sends two signals out to your body to cool down physiological signals. Like you go really red and you sweat because it's in an emergency situation. And then also for you to go, Oh, I'm hot.
Starting point is 01:02:00 And therefore I will behave in a way to cool myself down and take my jumper off. When you are asleep at night, your body's like doing the whole sweating thing, but sometimes you've got the covers on, but you're asleep. And so then your brain needs to wake you up. And some women describe it, and in my experience being 50, it feels a little bit like you've had a fright, like you wake up and you've gone, oh, it's not like just waking up normally. You can almost feel the adrenaline going through your body because your brain has had to wake you up.
Starting point is 01:02:32 Wake you up to behave in a way to also call you down because the sweating wasn't quite doing enough. Yes, by that point, it's like a puddle on my side of the bed. Yes. And then I'm like, how was I asleep when these sheets are so wet? And why am I so warm?
Starting point is 01:02:47 Yes. Yeah, and we know a couple of things. We know if we put estrogen back in with menopause hormone therapy or HRT, whatever you're gonna call it, we know that that kind of reset that thermostat. And we know that that's putting the estrogen back in as one of the best treatments for vasomotor symptoms.
Starting point is 01:03:02 What we're seeing, and some of the ideas are that body temperature and sleep are really intimately entwined, and every menopausal woman knows that, right? You might not know that if you're a young teenage fella, right? You might not have figured that out, but we all know that about 70% of the hot flashes that we have overnight, and so studies have found about 70% of the hot flashes will wake us up. You might not remember waking up, but your sleep's being disrupted. But even if you're not waking up,
Starting point is 01:03:31 that nice sort of, you know those sleep studies that you see where you got into deep sleep and then up into REM and down again, that just gets all, that nice, neat architecture just gets disrupted. So if that happened for one night, you would feel a bit rubbish. If that happens for a week and a month and for years on end, well, what's the inevitable
Starting point is 01:03:48 consequence of sleep disruption? Memory. Do you just feel terrible? You feel terrible. You're more vulnerable to depression. You're more vulnerable to memory problems. That's perhaps one of the reasons why we are seeing problems with what we would call brain fog. Well, Dr. Mackay, here's what I'm going to do for you. Ready? What I love about the way that you're teaching us and the rigor with which you're explaining the research and the science is that for somebody like me, who's just a person going through
Starting point is 01:04:21 this, and then I go, I blame it on menopause. I blame it on my hormones. I blame it on estrogen. You basically are saying that's part of the issue. However, if you look at the female brain and you look at what's happening when your body is going from this bottom up biological change and the hormones are changing, your brain is responding. Yes. biological change and the hormones are changing, your brain is responding.
Starting point is 01:04:45 And one of the big things that happens is it's interrupting your sleep because you're basically overcooking yourself as you're sleeping. And because that's happening over and over and over again, whether or not you remember waking up, the brain fog isn't, quote, necessarily because you're're lacking estrogen the brain fog is what's Accumulating. It's like your body. Yes, it's like a domino effect and What's that constant sympathetic activation multiple times a night? That's going to have a couple of different Consequences we see consequences for cardiovascular health and the same we would see with sleep apnea if someone like their sympathetic activation goes off to wake them up so they start breathing again.
Starting point is 01:05:31 And we know that that's really bad for cardiovascular health. And cardiovascular health is not great. Bad cardiovascular health means bad brain health. So we've got that kind of consequence. And we also see with repeated sympathetic activation for perhaps no reason that we, it's not like something out there was giving us a fright, but repeated sympathetic activation makes you more hypervigilant.
Starting point is 01:05:56 And when you're more hypervigilant on top of sleep deprivation, you're much more vulnerable to anxiety. And it's almost like your sympathetic nervous system has been activated multiple, multiple, multiple times. And so it becomes more hypervigilant. So you feel anxious, even though there's not necessarily anything
Starting point is 01:06:12 that has changed a lot. So there's a whole lot of different consequences there. So that could kind of feed in to the brain fog. So how can women protect or strengthen their cognitive health as they age? So there's some pretty clear data which has come out. I believe I wrote it down earlier. So there's some pretty clear data that has come out and the sort of the entire pool of
Starting point is 01:06:37 data that we've gathered from all over the world looking at Alzheimer's disease risk is kind of analyzed and put together every year by the Lancet commission of Alzheimer's disease. And they put this information out. And what they're saying currently based on the data to date is about 45% of cases of dementia and Alzheimer's disease could be prevented by intervening with various types of lifestyle factors. And this is like for males and females.
Starting point is 01:07:03 So that's quite high, right? 55% are probably biological things we can't necessarily already do much about. Okay, but 45%. Yeah, and so 5% of that is early childhood education. And that's quite a lot, right? So the more years you stay in education and the more enriched childhood experiences you have, the more protected you are.
Starting point is 01:07:24 And that's perhaps where we see some of that gender inequality in some parts of the world. And that could almost explain that incidence, that inflow differing between males and females in countries where there's the gender inequality in childhood. And bearing in mind, we could be looking at people in their 90s, so we're having to look at what their lives
Starting point is 01:07:41 were like 90, 80 years ago. Midlife is really interesting because we know So we're having to look at what their lives were like 90, 80 years ago. Midlife is really interesting because we know there is this factor which is responsible for about 7% of cases of Alzheimer's globally. And no one talks about it because it's deeply unsexy and it is hearing loss. Wait, what? Hearing loss? Yeah.
Starting point is 01:08:02 Untreated hearing loss in midlife. So we know the causes of the hearing loss, like listening to too loud music and industrial hearing loss, et cetera, and then perhaps you're just getting older. But what is it about hearing loss that is causing Alzheimer's disease? And we think partly it's around, well, what happens when someone loses their hearing? They can't interact with other people, they withdraw socially, they might withdraw from work, they kind of shut down. And remember, like, we're constantly receiving information about the world through our senses,
Starting point is 01:08:34 through our eyes and our ears, primarily as humans. And so it's just kind of cutting off one of these kind of sensory inputs that our brain is receiving. So that's, and no one's talking about that, it's not very like kind of fun and sexy to say, you know, go and get a hearing aid. It makes sense though. There are people that are out there saying that, but I don't think they're getting the kind of attention
Starting point is 01:08:54 they deserve. Dr. McKay, what is the next frontier of research in women's brain health that excites you the most? Well, now women's, I mean, I always say women's brain health is no longer a niche. And so I'm looking forward to seeing what, you know, comes out of that, like parent numbers, data. It's very nerdy. But I think that that's, that's what's going to give us the answers. Well, you are proving that women are in fact good at math and science. If you could give And science. If you could give the person listening one science-backed recommendation for caring for
Starting point is 01:09:31 the female brain, what would it be? What's the most important thing? Besides sleep, you can get that sorted. You're halfway there. I think when I first sort of started moving into women's brain health research, you know, I've been doing neuroscience for a long time. I thought it was all going to be about hormones, hormones, hormones, hormones. That was going to be what it's about.
Starting point is 01:09:51 But I think it doesn't matter at which life stage you are considering whether you're looking at infancy, childhood. We talked about girls going through puberty. We know what teenagers need, new mothers. You know, as we are aging, it's really about other people. And we have these, our brain is like a social organ and what it needs at every age and every life stage is social interactions with other people. And I think we tend to forget how important relationships are as determinants of health.
Starting point is 01:10:23 And we have that real tendency, as I said from puberty, to just blame the hormones and to only look for what's going wrong and not looking at how, I think, social infrastructural architecture can protect and promote that resilience and that adaptability. So I think other people are the key to a healthy brain. You know, one of the things that I think is also damaging that is out in the zeitgeist is that women are better at relationships than men, and women are more social than men, and men do not
Starting point is 01:10:59 have support structures. And while that may be true, the presumption is it's because they're not capable of creating it. And is that recommendation also true of the male brain? Yeah, that's true for humans. I mean, I've got teenage sons and, oh, I've got to feel like a cry thinking about them being sad and lonely. So yeah, that's just what humans need. But I think we do tend to, particularly with girls and women, zoom in on the hormones.
Starting point is 01:11:31 And we can't necessarily always do a lot about that. And that kind of removes the agency or the ability to kind of look beyond that to other people. And we just have so much research that often the strongest determinant of health outcome is other people. Dr. McKay, what's your parting words? I was thinking about this because all of the work that I talk about in all my books and teach and I write about, that's not research that I've done.
Starting point is 01:11:58 It is me talking about the work that other researchers have done because I don't work as an academic neuroscientist anymore. I'm a science communicator. And I just have so much to thank all of those researchers out there doing the work, like so many of them, like some of them are like women of steel who are asking these hard questions, battling for the funding and then seeking the answers. And it takes a really long time to do good science well. It takes time and money and you have to be meticulous.
Starting point is 01:12:32 And sometimes it's nuanced and sometimes it's mixed and sometimes the answer is still, we don't know. And so I think my parting word is I just want to like acknowledge them and thank them and cheerlead them because I couldn't do what I do. I'm just talking about the work that they've done. parting word is I just want to like acknowledge them and thank them and cheerlead them because I couldn't do what I do. I'm just talking about the work that they've done. So yeah, my parting word to them is just to say thank you. I love that. I'm going to say thank you too. And is there any final thing you want to say
Starting point is 01:12:55 to the person who has just spent all this time learning from you that you want them to know about their brain or the future that's possible for them? I think we have been told for centuries the story that women's brains are unstable and chaotic and dysfunctional and other than male. And our brains are actually like resilient and adaptable. And that's not just me saying that because it's a nice thing to say. It's really and truly what the neuroscience is showing. And so I know that there's gaps. I know that not everyone has the best life experiences.
Starting point is 01:13:39 But the research is showing us that there is a really good news story. And if we look for the strengths and we also tell ourselves the good stories, then we may be able to influence some more positive health outcomes along the way. Amazing. Thank you for being here. Thank you for inviting me. I learned so much from you today. No, seriously, like I feel,
Starting point is 01:14:02 my brain feels like popcorn is popping all over the place because you challenged me to think about this topic completely differently. It's very empowering to think that between your ears and on top of your neck is this incredible organ that is constantly adapting and has this crazy intelligent design. And when you understand the fact that it's only just responding to the input physically and from the world, you actually hand us the keys to think more critically about how to add positive input, how to stop buying the lies that we're being told about the way that women are or girls are or men are or boys are and to understand that it can always adapt and change.
Starting point is 01:14:52 And that's a very positive and encouraging thing. I just feel so much smarter. And I really appreciate you hopping on a plane, you coming all this way, you pouring into us. Thank you for the work that you're doing, this has been amazing. And I also wanna thank you. Thank you for taking the time to listen to something
Starting point is 01:15:12 that is gonna help you understand your mind and unlock the power of it. And in case no one else tells you today, I wanted to be sure to tell you that I love you and I believe in you and I believe in your ability to not only create a better life, but with a better understanding of the way that your mind works. I think you can unlock the power of it. And I can't wait to see what you do with everything
Starting point is 01:15:37 that you learn today. So thanks for being here. And I will see you in the very next episode. I'll be waiting to welcome you in the moment you hit play. I'll see you in the very next episode. I'll be waiting to welcome you in the moment you hit play. I'll see you there. We're gonna admit this is gonna be fantastic. Thanks. Of course. Thanks for having me.
Starting point is 01:15:54 Of course. Thanks for coming to my 50th birthday party tour. Came to see my friend Mal. Yes you did. Yes you did. So yeah, you're part of the birthday party. Well, thank you for including. When is your birthday in January?
Starting point is 01:16:04 It was in January 7th. 7th, that's my mother's birthday. Who is, you're part of the birthday party. Well, thank you for including. When is your birthday in January? It was in January 7th. 7th? That's my mother's birthday. Who is it? My husband is the 6th. Oh, really? Yes, lots of Capricorns. Happy 50th. Yeah, thanks very much.
Starting point is 01:16:13 Is that what you're doing? We're leaning into it, right? Okay. Wow. Holy cow. I need to pick my job off the floor. Whew. Great job.
Starting point is 01:16:22 How do you feel? That was fun. Good. That was awesome. You were awesome feel? That was fun. Good. That was awesome. You were awesome. Everybody's doing a good job. Oh my God.
Starting point is 01:16:33 Good job. Oh, and one more thing. And no, this is not a blooper. This is the legal language. You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes.
Starting point is 01:16:52 I'm just your friend. I am not a licensed therapist. And this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I'll see you in the next episode.
Starting point is 01:17:08 Sticher.

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