I’m not fond of goodbyes. Thankfully, in my native tongue, we do not say goodbye at all. Loosely translated, “arrivederci” means “until we meet again.” But before we do, I want to be certain that you turn the last pages inspired to blaze a happy, healthy trail ahead. With the strategies you’ve gathered in hand, I send you off serene in the knowledge that you’re headed for a straight-up Rinascimento.
I’m often asked to share my thoughts on “aging gracefully.” This expression is dear to my heart since it’s precisely what I wish for my family and friends, the patients I care for, and for those of you I meet through the pages of this book. That’s what I wish for myself, too. The gracefulness of age extends far beyond style, of course; it’s also the wisdom, intelligence, and thoughtfulness that come from a vibrant and resilient brain.
The concept of aging gracefully is, however, out of step with the youth-obsessed, results-oriented culture of the day. We live in a time that has stigmatized aging. Where many cultures have and still do admire and respect the benefits of maturing, what I see around us is a culture that dreads and avoids aging at every turn.
Where growing older is shunned, there arise endless options for looking younger, sparing no expense for medications, cosmetic surgery, or the free option of flat-out denial. Nowhere is this standard applied more harshly than it is against women. As men age, they are considered to be like a fine wine that increases in value. Instead, women are treated like milk—met with suspicion after a hypothetical “sell-by” date. As soon as a woman turns forty, ads start popping up about anti-aging tricks, tips to stay in shape, and ways to look good “anyway.” Before we attend to the health of our mind and body, it’s our exterior appearance we are urged to focus on.
Are we buying this bill of goods? Do we need to subjugate our well-being in the name of the conventions and customs that hobble us? Could our smarts be the emphasis on the covers of magazines, instead of attention to wrinkles and waistlines?
While one could argue that these questions apply to what both women and men confront in various ways today, it’s this book’s goal to focus on women’s health, and our brain health in particular. However clear it’s becoming that our brains possess singularly remarkable gifts, as women, our strengths come with risks that have been left unresearched and unsupported. For the many reasons discussed throughout The XX Brain, there are vulnerabilities attributed to this indispensable organ that are currently twice or more as common in women. These hazards hail in the form of Alzheimer’s and dementia, as well as depression and anxiety, among others. We acknowledge that this is the result of factors both biological and societal in nature, derived from our evolution, our history, and our society, as well as from the present-day powers that be. In spite of the gravity of these risks, many don’t exist because they’re biologically unavoidable; they exist due to misinformation and neglect.
For me, I am not having it. I’m not having it for myself, nor for my mother—and I’m certainly not having it for my daughter. If you’ve made it this far, I’m guessing you might feel the same. We’re not alone. As a devoted researcher in the field, I am working diligently alongside my global colleagues to reassess, reinvigorate, and level the field of women’s brain health, offering select screening procedures and interventions geared explicitly to the female physiology. In doing so, we intend to provide women with the care they merit as a fundamental human right.
The marvel of the female mind and the way it interlaces with its body’s many missions offers rich research territory. It deserves the curiosity, attention, and care necessary to establish an entirely new and updated standard in women’s health care. Given women’s ever-increasing contributions to society at large, the welfare of everyone’s future lies in our unflagging commitment to fulfilling this task. Ours is a moment that trembles with a great degree of change. Let’s put our foot down, appraise what’s lacking, and take what we need to clear these hurdles, a move that’s long overdue.
Seeing this through requires a series of shifts, and perhaps like the toppling of dominoes, it begins with those first actions we ourselves take before rippling through society. For the part that’s ours to do, I offer a means to an end via the research, recognition, and game plan laid out for you in this book. Together and individually, we can extricate ourselves from these current confines and their subsequent risks.
The primary means available to an individual is not legislation, research, or a magic pill. When it comes to brain health, prevention is everything. Although we are making advances every day to treat diseases once thought unavoidable, preventative strategies rather than pharmaceuticals show the boldest success in the field thus far. Intervening with these strategies in advance, and capitalizing on the windows of opportunity that pop up amid our hormonal ebb and flow, form the basis of this approach.
Typically, women’s health care involves some form of hormonal therapy, whether MHT, birth control, or anti-estrogen treatment. Every medication has potential risks and benefits. As women, we need to be aware of both sides of the coin to make smart, informed decisions that honor both our present and future health. At the same time, we merit options that have been thoroughly researched and carefully developed with respect for the health and well-being of our bodies and minds.
The female-sensitive interventions you now have in hand are at the very heart (and head) of this enfranchisement. They are tailored to safeguard the sophisticated workings of a woman’s mind, navigating the lifetime of hormonal evolution that defines our gender. Science reveals that a woman’s brain functions in accord with her body’s rigorous journey, alert to the manifold hormonal map of female adolescence, pregnancy, and menopause. We finally have a lifestyle program that respects these select criteria as women, fine-tuned to promote our cognitive health while enhancing our overall vitality and sense of self. By adequately assessing pharma and non-pharma options, optimizing diet and exercise, downgrading stress and upgrading sleep, while enriching our lives with the social, cultural, and intellectual offerings that fuel our minds as much as heal them, we can build the foundations on which to thrive, not just in the flower of youth but also in the strength of age.
To do this, we must reprioritize.
As the proverb says, “Eat half, walk double, laugh triple, and love without measure.” I don’t know any scientist who would argue with that. But this is not achieved overnight or with the attitude of finding a temporary fix. Although you may come across articles, apps, and dietary tricks claiming to “change your brain” in a matter of weeks, our work goes deeper and asks patience and persistence. Genuine change takes between three and six months to occur and lasts only as long as you continue to actively care for yourself. This is a forever plan, not just a quick fix. As with anything of excellence, it takes discipline, consistency, and commitment. The difference is, with this quality of investment in yourself, the benefits will last a lifetime—impacting not only you but also everyone you love.
In the end, we are indeed the sum of our parts. Perhaps it’s time to take a tip from our XX brain itself and tend and befriend: our brains, our bodies, ourselves, and one another. There is a mounting awareness around the things that need to change in the field of women’s health care and concerning women’s well-being overall. Now is the time to draw the line, express our needs, and address them.
I look forward to seeing the female mind and all that it achieves fully celebrated, duly appreciated, equally compensated, and downright admired. Until we meet again, know that I’m joining in with you as we pioneer the kind of care that women require and that women can provide.