The menopause mystery. This scientist is advocating for more women’s health research.
Scientist Liisa Galea
I don’t know about you – but I sometimes get confused on a mind and body level. I’m talking about unexplained mood swings and a struggle to remember things, amongst other stuff.
Something feels off.
But here’s the confusing part. What is bringing this about? Is it just the process of ageing that comes with… for example… worrying more? Is it part of parenting and the “growing up” that comes with it? Could it be some weird post-Covid symptom? The result of medication? Or could it be perimenopause or some other impact of hormones on my body?
I have no clue.
But I should. I want to know.
And the reason why I have no clue boils down to the fact that this - the impact of hormones on a woman - is vague to many medical professionals. And the reason for that is that there is not enough research into the matter.
One Canada-based scientist has made it her mission to advocate for the need for more research into women’s health. And guess what? She is half Maltese.
Liisa Galea – an advocate for women’s health research
Liisa Galea is a senior scientist who currently leads the Women’s Health Research Cluster at the Centre for Addiction and Mental Health (CAMH) in Toronto.
A former professor at the University of British Columbia, she obtained her PhD in neuroscience (Western University) and then moved on to postdoctoral training at the Rockefeller University.
Based in Toronto, Liisa is known as a tireless advocate for women’s health research and for sex and gender-based analyses to improve mental health for all.
Liisa’s father was born in Malta and moved to Canada when he was 18. She was born and raised in Canada and has visited relatives in Malta several times.
“I grew up at a time when girls were told they could not do certain things, and this never sat with me very well. My parents were very permissive of me exploring my intellect and I never felt hindered by them. But I felt hindered by society.
“When I started studying, I was always fascinated by the brain and questioned if there were differences between males and females,” she says.
“Then I got pregnant and there was little research about how hormones impact the way our brain works and wanted to understand why I was feeling a certain way.”
“When I started studying, I was always fascinated by the brain and questioned if there were differences between males and females… Then I got pregnant and there was little research about how hormones impact the way our brain works and wanted to understand why I was feeling a certain way.”
So as Liisa’s personal and professional life unfolded, the questions started piling up. The scientist in her wanted to understand how hormones influence the brain across a lifespan.
She believed gender must play a role. After all men and women experience different hormones. But the research into this was – and still is - very lacking.
“In the field of neuroscience research, there has been a longstanding view that it’s okay to just study males. In fact, only 5% of research in the field looks at the difference between males and females, while only 3% looks at females only. We need a lot of work in the area,” she insists.
This is why, through her research, she set off to fill this knowledge gap, specifically in understanding how sex, stress, and hormones – mostly oestrogens - influence neuroplasticity, that is the brain’s ability to change and adapt due to experience.
Her focus is on the hippocampus – the part of the brain that plays a key role in learning, memory and other key cognitive processes.
With almost 30 years of experience in the field, Liisa is now a world-renowned expert in sex hormone influences on brain and behaviour in both health and disease states, with a focus on dementia, depression and stress-related psychiatric disorders.
Pregnancy and menopause
And when talking about the influence of sex hormones on the brain one can not but mention the key hormonal moments in a woman’s life such as pregnancy and menopause.
Her research reveals novel insight into the mechanisms by which pregnancy impacts the risk for psychiatric disorders in the short term and the trajectory of cognitive ageing in the long term.
“During pregnancy and after, the brain, just like the body, undergoes a huge change and it should not be surprising - you are producing a human. That’s a huge accomplishment. It is also a dramatic influence on a woman’s life, brain and body. Pregnancy hijacks your system: you’re pregnant everywhere not just in your belly. It has a profound effect on the brain,” she says.
Her work also sheds light on menopause – during which high levels of hormones drop impacting the entire body and mind.
“What we forget is that hormones travel everywhere – in our breasts and uterus, but also in the bones and brain and muscle and joints and eyes. So it does make sense that, when we have a large reduction in these hormones we get all these diverse symptoms that show up: from hot flushes, night sweats, changes in mood, libido and physical changes. But there is so little attention to it, and this is such a disservice to women.”
“If you think about oestrogens and progesterone, these hormones are no longer being produced by the ovaries after menopause – the change is dramatic. What we forget is that hormones travel everywhere – in our breasts and uterus, but also in the bones and brain and muscle and joints and eyes.
“So it does make sense that, when we have a large reduction in these hormones we get all these diverse symptoms that show up: from hot flushes, night sweats, changes in mood, libido and physical changes. But there is so little attention to it, and this is such a disservice to women.”
Liisa believes that researchers, medical professionals, governments, and even women need to start demanding more in this field. Because the issues caused by menopause, for example, are impacting half of the global population.
“The first step is to really carefully document your symptoms and don’t let anyone tell you it’s all in your head.”
According to the World Economic Forum, spending more money on women’s health research can save the global economy $1 trillion a year. Women are at great risk of developing depression during perimenopause with the most at-risk time being immediately after giving birth for first time occurrence of mental illness.
“Many women will leave the workforce because of a number of symptoms and because they don’t get enough medical advice during menopause. Doctors are not properly trained as in many countries they get less than half of a day on what menopause is. This is unfortunate as half of the population will go through it,” she says.
In a recent article published in Times of Malta, gynaecologists acknowledged, that even in Malta, doctors’ training on menopause is minimal and women’s ‘change of life’ phase can often be sidelined. They spoke about the need for a dedicated clinic and the “HRT discussion”.
Liisa believes that women need to ask the questions. They need to take charge and listen to their bodies.
Women taking charge
“The first step is to really carefully document your symptoms and don’t let anyone tell you it’s all in your head,” she says. She gave the example of young women starting out on the contraceptive pill. In many cases, they speak up and consult if the pill does not work for them until they find the right one. The same needs to happen at the menopause stage with hormone therapy.
“If healthcare is your boat and healthcare providers are the crew, they still need a compass and a map to tell them where to go – and that is the research.”
Unfortunately, myths about hormone replacement therapy (HRT) still exist. The reputational damage of HRT is mainly due to a flawed Women’s Health Initiative study that shed a bad light on estrogen replacement and its connection to breast cancer. The now-debunked bad publicity about the ‘danger’ of HRT led to resistance to treatment, and though the study has been criticized by many, it instilled fear in both doctors and patients.
Liisa believes that the conversation needs to be louder.
“Don’t be ashamed to talk about it as friends are probably going through something similar. Find support. Don’t blame your doctor, but let’s start to demand more globally – more research and training for doctors. We need the research so we know what to tell doctors. If healthcare is your boat and healthcare providers are the crew, they still need a compass and a map to tell them where to go – and that is the research.”
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