Wellness
Opinion: Not ‘just stress’ – How hormonal changes affect women’s brain function
By Dr Louise Newson BSc(Hons) MBChB(Hons) MRCGP FRCGP DHealth
Over years of studying the health of women there’s one key thing that I’ve come to realise; clinicians have often been missing a crucial piece of the puzzle in understanding women’s mental health and brain function.
It all comes down to three hormones that deserve far more attention for their powerful influence on the brain — progesterone, estradiol, and testosterone.
As an example, I consulted with a 46-year-old woman last week in my clinic. She’s clever, accomplished, always been on top of things.
But recently she has been forgetting words mid-sentence, she can’t remember where she parked her car and finds herself having to read the same page three times and still nothing sticks.
Terrified that she has early-onset dementia, she visited her GP who told her it’s “just stress” or “normal ageing.”
But here’s the thing – it’s neither. It’s her brain responding to a dramatic hormonal shift, and we need to start talking about it.
Women’s mental health, and especially brain health, is deeply influenced by our hormones – progesterone, estradiol and testosterone – all three having fundamental roles in how our brains function.
However this connection is often overlooked in medicine and public conversations.
When levels of these hormones fluctuate and reduce (as they do during perimenopause and menopause) then this can have negative effects on our brain metabolism and function leading to symptoms such as memory problems, brain fog, poor sleep, low mood, anxiety, irritability and fatigue.
Menopausal women have an increased risk of developing dementia due to these hormone levels being low.
These vital hormones work to improve glucose metabolism, which provides the fuel our neurones (nerve cells) need to function and connect with each other.
They also work to reduce inflammation and improve the function of our mitochondria (the powerhouse of our cells) which all work to keep our brains healthy and working well.
Progesterone, estradiol and testosterone also increase neural growth, strengthen synaptic connections between nerves, and regulate levels of neurotransmitters such as serotonin for mood, acetylcholine for memory, melatonin for sleep and dopamine for motivation.
The presence of these hormones is linked to lower rates of memory loss and can reduce risk of Alzheimer’s disease, which affects women at nearly double the rate of men.
Importantly, “brain fog” and forgetfulness commonly reported during perimenopause and menopause are real and measurable phenomena linked to hormonal fluctuations, not just “normal ageing” or stress.
Testosterone is commonly misconstrued as “just a male hormone,” but women’s brains require it for optimal functioning.
Produced by ovaries and adrenal glands, as well as in the brain, testosterone supports cognitive sharpness, energy, and drive.
Emerging evidence links lower levels of testosterone in women to poorer performance on memory, processing speed, and even greater Alzheimer’s risk, especially among those with certain genetic risk factors.
Like estradiol, testosterone boosts dopamine activity, which is crucial for focus, motivation, and pleasure.
Many women report that restoring testosterone improves concentration, energy, and overall mental clarity.
Women’s mental health is closely associated with these changing hormone levels.
Rates of depression, psychosis and anxiety in women are more common at times of hormonal flux such as puberty, the premenstrual phase, postpartum, perimenopause and menopause.
Therefore, clinicians should certainly be assessing for hormonal factors when cognitive and mental health concerns arise in women.
Women represent nearly two-thirds of all Alzheimer’s patients, and much of this is likely driven by the neurological impact of hormone loss.
Understanding estradiol, progesterone, and testosterone as master regulators of brain metabolism and cognition should then lead to better clinical treatment.
This must take the form of more personalised approaches by clinicians, prescribing the right dose and type of hormone treatment, which when combined with a healthy lifestyle offers the best prospects for safeguarding and improving brain and mental health for women.
One of the reasons I developed the Balance app is to empower women with evidence-based information so they can make the choices that are right for them about their hormonal health.
Using technology to both monitor symptoms and learn more is so important – the response from our users has been so positive and inspiring.
Femtech has the ability to reach a global audience and transcend national borders and cultures which is really exciting for me to witness through our Balance app.
It has also enabled us to provide communities with large scale pools of information and support which are not so readily available in other ways.
Also, Balance is used to support and empower women, privately, who are too scared to communicate in the physical world.
We’ve ignored women’s brain health for too long.
Clinicians have too often dismissed symptoms, failed to account for the profound impact of these hormones on brain function, and have frequently accepted cognitive decline as inevitable.
It’s time for that to change.
Because understanding the hormone-brain connection and replacing the missing hormones isn’t just about preventing disease, it’s about helping women thrive, with their minds sharp, their memories intact, and their full cognitive potential realised.
Image Credit: Andrew Crowley
A new Female Health Hub launched by the English FA will support women and girls in grassroots football in England with trusted advice on health issues affecting play.
The hub brings together expert-backed guidance, practical tools and player insights in one place, giving women and girls practical advice and reassurance on female health in football.
It has four core aims: to help women and girls better understand their bodies and how female health affects performance and participation, to educate players on key health topics and when to seek further advice or support, to provide practical strategies to help navigate common female health challenges, and to help break down taboos and normalise conversations around female health in football.
Users of the hub will also be able to hear directly from members of the England women’s national team, who share their own experiences of navigating female health matters while playing at the highest level of the game.
“Our ambition is to create a game where women and girls can thrive,” said Sue Day, the FA’s director of women’s football.
“To achieve that, it’s essential that players feel supported in environments that understand and respond to their female health needs.
“We’ve heard directly from grassroots players that they want better information and support around female health, but that they often don’t know where to find it.
“The launch of the Female Health Hub marks an important step in changing the landscape.
“We want every player to feel confident in her own skin and supported without judgment, so she can feel empowered by her body, rather than held back by it.”
The platform was launched following research conducted by the FA that highlighted the need for better education and support around female health in football.
According to the FA, 88 per cent of adult players surveyed said their menstrual cycle has an impact on their ability to train or play, but 86 per cent reported they had never received education about the menstrual cycle in relation to football performance and training.
The research also found 64 per cent of women experience issues related to sports bras or breast health while playing football, despite sports bras being considered one of the most important pieces of playing kit.
Players also expressed strong interest in learning more about injury prevention, at 87 per cent, nutrition, at 84 per cent, and mental health, at 77 per cent, in relation to female health.
The first phase of the Female Health Hub focuses on three of the most requested topics: menstrual health, breast health and injury resilience, with further content to follow, including nutrition and pelvic health guidance.
Mariella Frostrup has been appointed the government’s women’s employment ambassador, a new role to support working women across the UK.
The new role comes as the government steps up efforts to support women with menopause symptoms, with businesses being encouraged to publish action plans aimed at tackling the £1.7bn lost each year through sick days, lost productivity and women leaving the workforce because of menopause.
The women’s employment ambassador role expands the remit of the menopause employment ambassador post, which Mariella Frostrup held over the past year.
In that role, she oversaw the launch of the Menopause Advisory Group and discussions with hundreds of employers to improve workplace support for women experiencing menopause.
In the expanded role, Frostrup will work closely with employers across the country to raise awareness of key health issues affecting women at work and champion the economic contribution women make.
Experts from across sectors will be brought together to gather evidence, identify barriers and opportunities, and provide informed recommendations on supporting women’s health at work.
Frostrup said: “Menopause support in the workplace has come a long way, and that progress is something to be proud of, but it cannot be where our ambition stops.
“Women’s health affects their working lives long before menopause, and for too long many have been navigating these challenges without the right support around them.
“Every woman deserves to know, at every stage of her career, that her health will not be a barrier to her success.
“I am delighted to take on this role and look forward to working with employers across the country support their imperative female workforce and retain them.”
Many health conditions affect women long before they reach menopause, including endometriosis and fibroids, making it vital that support is available throughout their working lives to stop women dropping out of the workforce for good.
This comes as part of the government’s drive to reverse the rise in the number of women who are economically inactive because of long-term sickness, which has hit a near-record high of 1.48 million.
Large businesses with 250 or more employees are also being encouraged to produce and publish voluntary action plans setting out how they will support employees experiencing menopause symptoms in the workplace.
Companies will be asked to commit to at least one action to support employees experiencing menopause, such as setting up support groups, tailored workplace adjustments including alternative uniforms, and more.
Dame Diana Johnson, minister for employment, said: “Too many women still face barriers that prevent them from reaching their full potential in the workplace.
“This new ambassador role sends a clear signal that we are serious about changing that, and Mariella Frostrup is the ideal person to take this on.
“By championing the brilliant contributions women make – as entrepreneurs, workers, and leaders – we can unlock economic growth that benefits everyone.”
The action plans are one part of the Employment Rights Act, which will boost employment and improve job security for more than 18 million workers and will benefit women balancing health, care responsibilities and careers.
Tracy Black, CBI chief commercial officer, said: “Businesses are committed to taking action to help women both stay and succeed in the workplace.”
“Awareness of the impact of menopausal symptoms at work is rising, leading to businesses taking a more pro-active approach to providing support. This is part of a wider trend of firms sharpening their focus on health and wellbeing.”
The women’s health ambassador, alongside the government’s renewal of the women’s health strategy, are working to make faster, more decisive progress on the health outcomes that matter most to women and girls across the country.
These measures, along with the new ambassador role, are intended to ensure employers are better equipped to support women and that women know how to access help throughout their career. Supporting women into work and throughout their career is a key part of the government’s commitment to Get Britain Working.
From spring 2026, employers with 250 or more employees will have the option to produce and publish a voluntary action plan alongside their gender pay gap.
Women with diabetes are less likely to get preventive care than those without the condition, a UCLA-led study suggests.
The findings are based on an analysis of more than 40 studies from several countries.
They highlight how physicians largely overlook the importance of these routine services for women who have diabetes mellitus, or DM, putting them at risk of preventable medical conditions such as pregnancy complications.
Lauren Wisk is associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA and senior author on the study.
She said: “These findings are important because they identify that women with diabetes are not receiving recommended well-woman care, which is essential to support both managing their diabetes and their overall health.
“Providers need to be aware that they should not forget to provide these essential services for women with diabetes.”
The researchers sifted through thousands of studies, focusing on the concepts of women, diabetes and women’s health services, and settled on 44 that addressed treatment services for women aged 15 to 49 with type 1 or type 2 diabetes, excluding those with diabetes insipidus or gestational diabetes.
They looked at four preventive health service categories: contraceptive counselling and use, breast and cervical cancer screening, pre-conception counselling, and screening for sexually transmitted infections.
One study found that 48 per cent of women with diabetes received contraceptive services compared with 62 per cent of women without the disease.
Nine papers showed cervical cancer screening rates ranging from 38 to 79 per cent for women with diabetes compared with 46 to 86 per cent for those without diabetes.
Four studies found that breast cancer screening rates for women with diabetes ranged between 38 and 69 per cent compared with 54 and 82 per cent for those without diabetes.
Fourteen studies found pre-conception counselling rates of just over 1 per cent compared with 46 per cent for women with diabetes who are planning to get pregnant.
The researchers did not identify any studies on screening for sexually transmitted infections, which they said represents “a substantial gap in the literature.”
The researchers wrote: “One of the more striking findings of this review is the importance of robust coordinated care teams in ensuring access to appropriate services for women with DM.
“Several of the identified studies provide support that a co-management model, or the concept of involving endocrinology, primary care, and other specialty care providers in the care of individuals with DM, as recommended by the American Diabetes Association, is associated with greater receipt of services.”
Within the time constraints of an office visit, primary care physicians are expected to address preventative health needs as well as chronic disease management, said Dr Lisa Kransdorf, an associate clinical professor of medicine at the Geffen School and a study co-author.
She said chronic disease management will often take priority.
“In cases where the patient has other providers such as specialists and clinical pharmacists actively involved in their chronic disease management, there is opportunity for primary care physicians to attend to preventative care gaps,” the researcher added:
There are some limitations to the findings.
The search yielded only 44 studies, many of which relied on patient recall, which can be unreliable, highlighting the need for further research.
In addition, most of the studies analysed had small sample sizes or were conducted at a single site, limiting how applicable the findings might be in other settings.
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