Introduction
Hello from The Livelong Woman! Your Wednesday dose of science-backed insights on living longer, healthier, and stronger, all through a woman’s lens. This week, we’re discussing the female brain’s unique way of aging and why hormonal care is, in fact, brain care.
This newsletter focuses specifically on women’s health and longevity. If that’s not relevant to you, no problem—you can opt out of just the Livelong Woman while staying subscribed to everything else.
The Science of Staying Sharp
The female brain isn’t just different, it’s remarkably adaptable. From hormonal shifts to neural plasticity, researchers are discovering that women’s brains have hidden strengths that could hold the key to longevity. But there’s a paradox: women outlive men in nearly every country, yet nearly two-thirds of those living with Alzheimer’s are women. New science is uncovering why. And how we can stay sharper, longer.
Photo by TSD Studio on Unsplash
Dr. Kevin Rynearson, head of research at CogniSHIELD, says part of the Alzheimer’s gap comes down to biology. “There are structural and genetic differences that make women more susceptible,” he explains. Studies have shown that, on average, women have a higher proportion of gray matter (the brain’s “thinking” tissue) while men have more white matter, which connects different brain regions. Because dementia primarily affects gray matter, that structural balance may help explain why women are more vulnerable.
Add to that the fact that women who carry the APOE ε4 (pronounced “A-P-O-E-epsilon-4”) gene variant face a higher risk of Alzheimer’s and faster cognitive decline than men with the same variant, especially in the decade after menopause, and the odds shift further against women. This gene increases the buildup of amyloid plaques and tau tangles, abnormal proteins that accumulate in the brain and disrupt communication between neurons.
“Amyloid is the match that lights the tangles, which spread like brush fires and ultimately incite a wildfire called neuroinflammation,” Rynearson says.
Hormones play another critical role. Estrogen protects the brain, but during perimenopause and menopause, levels fluctuate or fall sharply. Rynearson says that Hormone replacement therapy (HRT) can help mitigate the impact of these transitions, but timing and working closely with your clinician is key to success. Psychiatrist Dr. Sarah Oreck notes that these hormonal shifts are “wildly underrecognized as mental health events” and supporting women through them can protect brain function for decades.
The Bright Side
The same factors that protect your heart and hormones also support your brain health. Rynearson points to a simple set of habits developed in collaboration with Alzheimer’s researcher Dr. Rudy Tanzi, of Massachusetts General Hospital and Harvard Medical School, known as SHIELD:
Sleep well
Handle stress
Interact socially
Exercise
Learn new things
Diet: Eat a nutrient-rich one
“Data show these habits can reduce amyloid buildup and delay the onset of neuroinflammation,” Rynearson says. “Small steps can create big changes.”
New research is expanding the toolkit, from better diagnostics to personalized nutrition, but the foundation remains the same: sleep, stress management, movement, and connection. The World Economic Forum recently highlighted how advances in neuroscience are reshaping the way we eat, suggesting that what we put on our plates may play a crucial role in supporting brain longevity. Rynearson adds, “Nearly half of dementia cases could be delayed or prevented by addressing lifestyle factors. This puts the power directly in the hands of women.”
The best news? It’s never too late to start, and every small shift matters.
Poll
Which brain-healthy habit do you most want to strengthen right now?
Mindfulness
Photo by Simon Hurry on Unsplash
The Health Benefits of a Meaningful Life
Longevity is about making the years you have count deeply. Neuroscientists call this “purpose-driven resilience”: the idea that meaning, connection, and curiosity protect the brain as much as nutrition and exercise do. Studies show that people who feel a strong sense of purpose have better memory, lower stress hormone levels, and even a reduced risk of dementia.
Building a life worth living doesn’t mean reinventing everything. It starts with noticing what energizes you. Is it the morning walk that clears your mind, the conversation that lingers, the small acts of learning that make your brain spark? Each of these choices strengthens neural networks linked to joy, motivation, and cognitive longevity.
Your challenge this week is to tune into those moments that make a difference. And then figure out how you can find more of them in your week.
Why Hormonal Care Is Brain Care
Dr. Sarah Oreck, MD, MS, founder of Mavida Health, is one of a small number of psychiatrists with specialized training in reproductive psychiatry. Trained at Columbia, she blends evidence-based medicine, talk therapy, meditation, and a whole-body approach to support women’s mental wellness across the reproductive lifespan.
“Postpartum and perimenopause are two of the most challenging hormonal transitions women face, yet they're wildly underrecognized as mental health events,” says Dr. Oreck.
Q. How do hormonal transitions affect women’s mental and cognitive health?
A. “Estrogen and progesterone drop faster than any other biological event after childbirth, while fluctuating estrogen during perimenopause and menopause can trigger depression, anxiety, and brain fog that women are told to just ‘deal with.’”
Dr. Oreck emphasizes that brain fog is a neurochemical shift—not a character flaw—and that untreated mental health issues during these transitions may affect long-term brain health. “We’re talking about protecting brain function for decades, not just feeling better today.”
Q. What practices best support women’s mental health over time?
A. Dr. Oreck points to three fundamentals: “Prioritizing adequate sleep, incorporating daily movement, and cultivating authentic connections.” Strong friendships, she adds, are consistently linked to improved mental and physical health.
She also encourages women to “seek support early rather than waiting for a crisis,” noting that therapy, medication, and education about hormonal changes are powerful preventative tools.
Q. What’s one thing you personally do to support your mental health?
A. “I block time for myself in my calendar and everyone knows it’s non-negotiable,” she says. That might mean therapy, a walk outside, or sitting with a matcha. As a mom of three, she and her partner “tag-team the chaos” by coordinating schedules. For Dr. Oreck, protecting time for self-care is what makes it possible to be fully present for her patients, her company, and her family.
The Watchlist
This week’s Watchlist dives deeper into how our brains age — and what science says we can do to keep them resilient. Let us know which one sparks your interest most!
What’s on our radar
How Alzheimer’s Changes the Brain:
A clear 4-minute animation that shows what happens inside the brain as Alzheimer’s develops — from amyloid buildup to neuron loss — and where new treatments are aiming. A great visual primer for anyone thinking about prevention and longevity.
Five Ways to Extend Your Healthspan:
In this National Geographic article, science journalist Maryn McKenna breaks down the latest longevity research into five actionable steps, from movement bursts and stress reduction to social connection. It’s a hopeful, evidence-based guide to staying sharper and stronger as you age.
Why Is Alzheimer's Disease More Common in Women:
This new paper explores why women experience Alzheimer’s more often and why our cognition may decline faster under the same disease burden. Researchers point to hormonal, immune, and tau-related differences that deserve far more attention in brain-aging research.
Poll Response
We asked, you answered:
What’s Your Go-To Skincare Routine?
“I keep it simple: cleanse, moisturize, SPF, done” was our most popular answer by far with several readers telling us they were picky about their products.
How was today's newsletter?
The information provided about wellness and health is for general informational and educational purposes only. We are not licensed medical professionals, and the content here should not be considered medical advice. Talk to a doctor before trying any of these suggestions.