When the Brain Leads the Way in Women’s Health

Good Morning!

This week’s lead isn’t “another conference recap.” It’s about what happens when we finally look at the brain through a sex- and gender-aware lens—and what that means for research, reimbursement, and care.

I’m moderating next week’s Museum of Science Boston session, Investing in Our Brains: The Hidden Story of Women’s Brain Health, where we’ll unpack how brain science connects the dots between hormones, policy, and economics. Because studying women’s health doesn’t just fill data gaps—it sharpens our understanding of everyone’s health.

Inside:

• 🧠 Highlights from the Women’s Health Horizons brain health discussions

• 📊 CPT codes, referrals, and data gaps that still limit care integration

• 🎟️ Panel preview: how brain health is shaping the future of innovation

• 🗞️ Roundup: FDA microneedling alert, new menopause nutrition book, Mayo Clinic study, cognitive labor research, and a Halloween-worthy women’s health fact

Let’s get into it.

SPOTLIGHT

🧠 The Brain Gap: What Science Missed About Women’s Brains

At this year’s Women’s Health Horizons, emerged: women’s brain health sits at the center of everything we call “women’s health.” Yet even as science advances, we still tend to study the brain as if it were universal rather than deeply shaped by sex and gender. The truth is, the brain is incredibly complex—and while researchers are working to understand it, we’re only beginning to explore how biological and social differences play out across the lifespan.

As I prepare to moderate next week’s Investing in Our Brains panel at the Museum of Science, I spoke with Dr. Jill Goldstein, who reminded me that studying women’s health actually teaches us a great deal about men’s health too. It’s a two-way street. Understanding these connections benefits everyone.

Researchers like Dr. Roberta Marongiu of Weill Cornell, Amy Green of Mamaya Health, and Angelika Fretzen of the Wyss Institute at Harvard all pointed to the same gap: hormonal transitions such as pregnancy, perimenopause, and menopause aren’t tangential—they fundamentally reshape brain chemistry, structure, and risk. When those changes go unrecognized in diagnosis, coding, and clinical care, the downstream effects ripple across the healthcare system.

What’s emerging

The brain literally rewires itself during major hormonal transitions. As Amy Green explained, a woman’s hippocampus shrinks during pregnancy—not because she’s forgetful, but because the brain is reorganizing to heighten attunement and protection. These neurobiological shifts can enhance empathy and vigilance, but they also increase sensitivity to stress and sound. Without understanding that, we pathologize what’s adaptive.

Dr. Marongiu’s lab is showing how menopause may influence dopamine and estrogen signaling in ways that elevate risk for Alzheimer’s and Parkinson’s disease. At the Wyss Institute, Angelika Fretzen’s team is building organoid and “organ-on-chip” models that finally let researchers study estrogen’s role in neural activity—something animal models could never capture. Together, these advances are reframing menopause as a brain event, not just a reproductive milestone.

What’s still missing

Even with this progress, women’s data remain largely invisible. Massive datasets on Alzheimer’s and Parkinson’s rarely include menopausal status or hormone therapy use. That omission makes it nearly impossible to identify early biomarkers or validate gender-specific treatments.

On the clinical side, the lack of integration is equally striking. When a woman visits her OB-GYN, her cognitive or emotional symptoms are rarely noted; when she visits a neurologist, her hormonal history is almost never captured. The absence of cross-specialty referrals or shared data reinforces a fragmented picture.

Amy Green highlighted how CPT codes themselves can perpetuate bias. To get reimbursed for conditions like anxiety or cognitive fog, clinicians must label them as psychiatric disorders rather than hormonally driven phenomena. Once coded that way, women are flagged as “higher cost” patients, which can affect future coverage. It’s a stark reminder that the system’s architecture—not just the medicine—needs redesign.

Why it matters now

Brain health begins long before menopause—or even birth. It starts in the womb and evolves across every hormonal and developmental stage of life. Each transition—puberty, pregnancy, perimenopause, aging—shapes the brain in unique ways. If we don’t study and support those stages systematically, we miss opportunities for prevention, early diagnosis, and long-term resilience.

More than 50 million women are currently in menopause, representing just one of many neurological inflection points. But focusing only there risks overlooking decades of brain adaptation that precede it. A lifespan approach to brain health means understanding the hormonal, genetic, and environmental factors that influence cognition, mood, and disease risk for all of us.

As Angelika Fretzen emphasized, “diagnostics, diagnostics, diagnostics” must come first. The science exists—from extracellular vesicle tracking to AI-driven modeling—but without coordinated data collection and shared frameworks, innovation remains fragmented. Brain health is a continuum, not a chapter, and it’s time our systems treated it that way.

Where we go from here

The path forward lies in integration—bridging research, care delivery, and reimbursement. Academic–industry partnerships that align diagnostics and therapeutics can close the loop. Meanwhile, care models that embed behavioral health within OB-GYN settings and create bidirectional referrals between neurology and women’s health can help ensure no woman’s brain health is dismissed as “just hormones.”

This is the systems thinking women’s health has needed all along.

Stay tuned

Next week, I’ll be moderating Investing in Our Brains: The Hidden Story of Women’s Brain Health at the Museum of Science Boston. Together with Dr. Jill Goldstein, Dr. Megan Greenfield, and Dr. Mike Quirk, we’ll explore how brain health connects science, economics, and business—from clinical trials and diagnostics to the financial impact of not investing in women’s health.

🎟️ Register for free event: mos.org/subspace

If your organization is exploring how to connect these dots—whether through landscape assessments, patient engagement strategy, GTM planning, or cross-sector partnerships—I help teams turn insight into action.

Let’s make women’s health innovation work for the system and the people it’s meant to serve.

ROUNDUP

What Caught My Eye

💊 FDA Warning on RF Microneedling

The FDA issued a safety alert after reports of burns, scarring, fat loss, and nerve damage from radiofrequency microneedling devices.
Experts say the statement lacked specifics but underscore that these are medical procedures—not at-home treatments—and outcomes depend heavily on practitioner skill.
👉 Read the Medscape report

📘 Eat to Thrive During Menopause by Jenn Salib Huber

A new science-based nutrition guide to ease symptoms of perimenopause and menopause—backed by research and written by a registered dietitian–naturopathic doctor. Includes 55 recipes built around five key ingredients: soy/phytoestrogens, protein, calcium, omega-3 fats, and fiber.
👉 Explore the book

🧠 Mayo Clinic: Most Women Don’t Seek Menopause Care

A new Mayo Clinic study finds that the majority of midlife women experiencing menopause symptoms do not seek medical help—highlighting ongoing gaps in awareness, support, and care access.
👉 Read the Mayo Clinic summary

🧩 The Hidden Mental Load: Cognitive Labor & Gender

A new study in Socius reveals that women’s “cognitive labor” — the mental work of anticipating and managing household needs — doesn’t decrease with higher earnings or full-time employment. The authors call it “gendered cognitive stickiness”: once mental tasks attach to women, they tend to stay there, regardless of resources or intent to rebalance.
👉 Read the research

🪚 The Chainsaw’s Surprising Origin

Invented in the late 1700s to help doctors deliver babies, the first chainsaw was a hand-cranked surgical tool for cutting bone and cartilage during obstructed labor—no anesthesia, no sterile instruments. A grim reminder of how far women’s health has come—and how far we still have to go.
👉 See the post

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