Podcast Summary: The Happiness Lab with Dr. Laurie Santos

Special Episode: Listen Now – Decoding Women’s Health with Dr. Elizabeth Poynor
Release Date: November 3, 2025
Host: Dr. Laurie Santos (Preview featuring Dr. Elizabeth Poynor)
Featured Guest: Dr. Carolyn Gurvich (Neuropsychologist, Monash University)

Episode Overview

This episode serves as a feature and preview of the new podcast Decoding Women’s Health with Dr. Elizabeth Poynor, focusing on the science behind women’s health during midlife, particularly cognitive and emotional changes associated with perimenopause and menopause. Dr. Poynor is joined by neuropsychologist Dr. Carolyn Gurvich to discuss how hormonal shifts impact cognitive functions, why many women develop symptoms resembling ADHD, and practical strategies for maintaining brain health through this life phase. The conversation integrates medical expertise with personal experiences and actionable advice for women seeking clarity and support for cognitive symptoms in midlife.

Main Discussion Points & Insights

The Gaps and Myths in Women’s Midlife Health

• Information Gap: Dr. Poynor discusses the lack of clear, reliable information regarding women's health post-reproductive years, noting the dearth of formal education even in top medical programs. [06:15]
  • Quote: “There’s maybe at best one or two lectures on midlife women’s health. There’s no textbook, there’s no course, there’s no focus on women after their reproductive years. And that’s why I’m making this podcast.” – Dr. Elizabeth Poynor [08:32]

Hormonal Changes and Cognitive Symptoms

• Hormonal Fluctuations: Perimenopause is marked by fluctuating and then declining estradiol (estrogen), lasting 4-10 years, and is associated with symptoms such as brain fog, memory lapses, and executive function challenges. [12:42]
• Prevalence: About 60-70% of midlife women experience some cognitive symptoms during perimenopause, ranging from subtle to significant. [14:14]

Impacts on Work and Identity

• Workplace Effects: Symptoms such as word-finding difficulties and decreased multitasking abilities often impact high-functioning professionals, sometimes leading to career changes or reduced self-esteem. [17:30]
  • Quote: “It’s really devastating when that’s happened... because of their sort of more subtle cognitive symptoms and then the flow on impact on self esteem and then the increase in anxiety, that chain of events has led them to leaving the workplace.” – Dr. Carolyn Gurvich [17:59]
• Practical Support: Suggestions include written communication over verbal, structured workdays, and strategies to reduce multitasking demands. [19:29]

ADHD-Like Symptoms in Menopause

• ADHD in Midlife: Many women wonder if they’ve developed ADHD due to new or worsening symptoms. Dr. Gurvich clarifies that true ADHD is a neurodevelopmental disorder but hormonal changes can worsen “inattention” or “executive dysfunction” traits or unmask existing ADHD. [24:10]
  • Quote: “For menopausal women, it tends to be more of the inattention... difficulty regulating and organizing and structuring your day can often go unnoticed.” – Dr. Carolyn Gurvich [24:49]
• Hormonal Link: Estrogen regulates neurotransmitters like dopamine and serotonin, influencing attention, focus, and mood. The fluctuating levels during perimenopause can either exacerbate underlying ADHD or mimic its symptoms. [27:45]

Estrogen, Cognition, and Dementia Prevention

• Estrogen’s Role: Plays a neuroprotective role in the brain, modulating neurotransmitters vital to executive function and mood. Loss of estrogen is linked to cognitive changes in midlife women. [27:45]
• Research & Guidelines: Hormone therapy is not widely endorsed for dementia prevention due to mixed results in major studies (e.g., Women’s Health Initiative), particularly when therapy starts well after menopause. However, newer research (and clinical anecdotes) supports possible cognitive benefits if started close to menopause (the “critical window hypothesis”). [35:11]
  • Quote: “There was a meta-analysis... showing that if hormone therapy was initiated close to menopause, then it was associated with a reduced risk of developing dementia later in life, particularly estrogen-only hormone therapy.” – Dr. Carolyn Gurvich [34:39]

Cognitive Training and Building Cognitive Reserve

• Cognitive Training: Effective strategies include psychoeducation, learning mnemonic and organizational techniques, and building “cognitive reserve” through lifelong learning and engagement.
• Brain Plasticity: The brain can forge new pathways at any age; effective training focuses on generalizing skills to daily life rather than rote repetition (e.g., not just “getting good at Wordle”). [41:40], [45:04]

Lifestyle Recommendations for Cognitive and Brain Health

• Exercise: Both strength and cardiovascular training are recommended; the ideal is five 30-minute sessions per week, but any exercise is better than none. Exercise is as potent as antidepressants for mood and cognition. [51:58]
• Nutrition: A Mediterranean diet (rich in fruits, vegetables, fish, nuts, and healthy oils, low in processed foods) is optimal for cognitive and cardiac health. Increasing protein and reducing processed carbs may be especially helpful. [52:43]
• Sleep: Treat disrupted sleep, possibly with CBT for insomnia; don’t ignore chronic sleep issues. [45:36]
• Stress Management: Practice meditation or mindfulness to lower stress and foster brain health. [46:45]
• Alcohol: No level of alcohol is beneficial for brain health; excessive drinking is neurotoxic and worsens sleep and vasomotor symptoms. [49:39]
• Social Connection: Strong social ties are crucial for cognitive health and well-being—even online communities can be beneficial if they provide real support and a shared sense of belonging. [53:49]

Notable Quotes & Key Moments

• On being dismissed or misunderstood:
  “What’s wild is that none of my doctors, not my therapist... not even my medical colleagues suggested perimenopause.” – Dr. Elizabeth Poynor [06:15]

• On cognitive symptoms and work:
  “The key factor for women to know is that it’s not an impact on intellectual capacity per se... but they just might need a little bit of support and a little bit of knowledge...” – Dr. Carolyn Gurvich [18:34]

• Dr. Gurvich’s 3 Takeaways for Women:

  • Awareness: Know hormonal changes may be behind shifts in mood and cognition.
  • Seek Help: Don’t suffer in silence—work with practitioners knowledgeable about menopause.
  • Lifestyle Change: Brains are always changing—implement practical lifestyle changes for cognitive health. [56:19]

• Dr. Poynor on Proactive Health:
  “At 35, 40, 45, how you treat your body today is really, you’re going to feel it when you’re 70 or 80. So super important to set yourself up for success.” [58:04]

Timestamps for Major Segments

• Intro & Episode Theme [00:00–04:08]
• Personal Story and Motivation (Dr. Poynor) [04:08–10:06]
• Meet Dr. Carolyn Gurvich & Brain/Hormone Overview [10:06–12:32]
• Perimenopause, Cognition, and Symptom Prevalence [12:32–14:40]
• Symptoms, Workplace Impact, and Support Tips [14:46–20:52]
• The ADHD Question in Midlife Women [23:51–27:45]
• Estrogen's Role & Dementia Prevention Debate [27:45–37:14]
• Cognitive Training & Lifestyle Approaches [41:26–49:12]
• Alcohol, Exercise, Nutrition Details [49:12–53:23]
• Social Connection & Community Advice [53:23–54:41]
• Optimism, Research Gaps, and Takeaways [54:41–58:19]
• Episode Wrap, Next Topic Preview [58:39–end]

Closing Thoughts

This episode illuminates the realities of midlife women’s health—dispelling myths about “the change,” highlighting the profound role of hormones in cognition, and championing a proactive approach. Dr. Gurvich’s evidence-based insights and Dr. Poynor’s advocacy merge science and compassion, empowering women to seek answers and support.
The central message:
"Brain health is not a passive endeavor... There’s so much we can do to build positive pathways in our brains.” – Dr. Carolyn Gurvich [56:52]

For anyone experiencing or anticipating cognitive or mood changes in midlife—or supporting someone who is—this episode offers both validation and a practical roadmap toward clarity, resilience, and empowered health.