It may shock you to learn that it’s only been within the last decade that scientists have been exploring the changes the female brain undergoes through puberty, pregnancy, parenthood and menopause.
In today’s episode, we are joined by Dr Sarah McKay, a renowned neuroscientist, author and educator who specialises in women's brain health. In this fascinating discussion, we explore the intricate nuances of female neuro-physiology, and how brain development is shaped or even remodelled during periods of significant hormonal change, such as adolescence, motherhood, and menopause.
Bec and Sarah also discuss what separates a male brain, from a female brain and how our life experiences shape and change women’s brain health. Dr McKay also shares her perspectives on the importance of friendships and connection and what the data reveals about the impacts of oral contraceptives as well as the quantifiable risks for women for dementia and post-natal depression.
Key Takeaways
- Experiences across a woman's lifespan, including education, socioeconomic status, and parenting, significantly impact brain development, often more than biology alone.
- Pregnancy brings forth notable changes in a woman's brain structure that prepare her for motherhood, often misunderstood as maternal instinct.
- Adolescence and pregnancy are pivotal biological events with comparable brain changes, signified by neural pruning and adaptation.
- Social support plays a crucial role in mitigating postpartum depression, superseding solely biological factors.
- Real-life experiences, varying by culture and socioeconomic conditions, crucially shape individual brain trajectories and health outcomes.
Episode Timestamps
00:00 | Exploring Women's Brain Health Across Life Stages
04:39 | Gender Equality's Impact on Brain Development Differences
11:54 | Understanding Gender Differences in Dementia Incidence Globally
15:29 | Exploring Menopause, Brain Fog, and Evolving Conversations
18:59 | The Impact of Early Childhood on Lifelong Brain Health
25:38 | The Impact of Oral Contraceptives on Adolescent Brain Development
32:57 | Hormonal Changes and Brain Adaptation During Pregnancy and Adolescence
39:56 | Postnatal Anxiety and Intrusive Thoughts in New Mothers
42:48 | Hormonal Changes and Stress Reactivity in Pregnancy and Lactation
47:11 | The Emotional Challenges and Transformative Journey of Motherhood
52:01 | Key Factors for Maintaining Brain Health and Reducing Dementia
55:22 | Embracing Ageing, Female Friendships, and Upcoming Book Releases
Episode Transcript
0:00:00 - (Bec Guild): My guest today is Dr. Sarah McKay. Sarah is a neuroscientist who translates brain research into workable strategies for professionals. She helps take complex scientific concepts and deliver them in an informative, relevant and entertaining way. I have been following Sarah's work for quite some time and I am really excited to have her here to discuss women's health and also the developmental changes that the brain goes through during adolescence, pregnancy, menopause and beyond. And without further ado, I warmly welcome Sarah.
Sarah, thanks so much for joining me for this chat. I'm so excited. I'm a bit of a fan girl of your work. I've been following it for a while.
0:00:43 - (Dr. Sarah McKay): Gosh, I hope I live up to expectations.
0:00:49 - (Bec Guild): Well, yeah, I did. When I joined myBrainCo, I was, you know, doing such a deep dive into the world of brain health and you were probably, probably one of the few people that were really talking about the female brain and some of those subtle nuances that exist around, you know, female physiology versus male physiology. And so, you know, I was doing my own journey, learning more about brain health and what I came to learn was there's this massive surge in neurological disease and neurological illness and that it's one of the biggest contributors to death and disease in particular. It's like, the second, dementia is the second leading cause of death for women. Before we dive right in, in the. I'd love to know first what it was that got you interested in brain health.
0:01:34 - (Dr. Sarah McKay): Well, I've been a neuroscientist since, like, I was at uni as an undergraduate and I, I just love, love the discipline because it's… There's just always some new, whether it be finding or sort of technological advance, or level of understanding. Even like yesterday I was reading some stuff, I was going, oh, my God, that's just completely blown my mind, it was actually around dementia, so we can talk around that. And it's that constant discovery and finding and learning out new things within the neuroscience discipline that has made me just as excited as I was yesterday as when I, you know, first learned about synapses and a Psych 101 lecture in 1993 when I was an undergraduate university. And that was when I changed. I was doing sort of a basic health sciences first year and went “I'm going to study neuroscience forever.”
0:02:30 - (Bec): Yep.
(Dr. Sarah McKay): And I did work in universities, you know, as a medical researcher within neuroscience for a number of years, but then sort of moved out to do my own thing. When I had my kids, I wanted to be, wanted to be at home with them and just have kind of like a chilled, you know, slow paced little childhood for them. They're now teenagers and I feel like I achieved that. And, and I suppose the interest in brain health really came from talking about neuroscience, but realizing that people weren't always interested in the same nitty gritty sort of neurophysiologic synaptic plasticity that I was. But more so what does that mean for me as a person in my health going forward?
(Bec): Yep.
0:03:13 - (Dr. Sarah McKay): So initially it was me kind of responding a little bit to the questions I was being asked. But what I have noticed within the last sort of five or ten years is that the data that we are starting to see emerge is actually something that we can make meaning of in terms of brain health, wellbeing and in particularly women's health, which is where I've kind of become really interested. So it's been kind of a slow burn, the health sort of side of it. I still do love a little bit of synaptic physiology, but, you know, it's nice to start to see some really cool new data emerging.
(Bec): Yep.
(Dr. Sarah McKay): Yeah, I'm quite enjoying learning about all of that still. Like every day I'm like, what? Yeah, that's so cool.
0:03:58 - (Bec Guild): It's sort of one of those things or what I found when it comes to brain health and brain wellbeing is like the more I dive in and I, and I learn and I ingest information, the more you realize how much we, I don't know or didn't realise or are still discovering about brain health. Like there's, it's got to be the most complex system, but the most fascinating.
(Dr. Sarah McKay): 100%.
(Bec): And I mean like to, to segue to the female brain. I mean there's a lot of memes and graphics that jokingly depict the simplistic versus the complex differences between the male and female brain. But I think if I've learned anything from following your work is that it's not that cut and dry and that there's actually quite a lot of things that might surprise people that truly shape women's brains versus males brains. So, can we go into that? Because I think that's so fascinating.
0:04:56 - (Dr. Sarah McKay): Yeah, yeah. So it's. Brains are as, as complex as like kind of worlds. Right? I think we can't like kind of look at a brain, like pick up, like this is not actually real brain, it's like a plastic brain. But like look at it and go, well, it's pink, it's a girl's brain, blue, it's a boy's brain, it's it's, it, there's a lot going on. Like you've got like just this kind of overall size and structure, but then we've got like hundreds of different kind of working nodes within here that have different sort of sizes and shapes and volumes which change and grow and respond based on our biology, but also based on what happens to us. And then there's the kind of the microscopic structure and then there's the neurophysiological function and then there's the biochemistry. But then this brain is also living in a body which could be a male body or a female body, but then that male or female person has this, this whole host of different life experiences all the way through their lifespan, depending on who they are and where they grow up.
(Bec): Yep.
0:05:55 - (Dr. Sarah McKay): Yeah. So, you know, we can kind of look at sex differences in terms of male and female development and utero and see that male and female brains like developed like pretty, pretty similarly. But the male brain and body and embryo is kind of bathed in testosterone because a little male embryonic baby will grow testicles and release testosterone. And we know that the testosterone kind of primes the brain or kind of patterns the brain in males to then respond to testosterone and puberty.
The female brain isn't exposed to any hormones, including estrogen, including its own mother's estrogen, just kind of, it's like follows this sort of default developmental pattern, but in doing so is primed and prepared at puberty to be able to respond to sex steroid hormones at puberty. But there's a whole lot of living that's done between birth or even a utero life and puberty. We can sort of start to look at like little children's brains and go, is there sort of any sort of structural or functional difference?
0:07:01 - (Bec Guild): Yeah, I think I read in your book that you said a newborn brain is like a rough draft, ready for editing. I thought that was really interesting.
0:07:08 - (Dr. Sarah McKay): Yeah, ready for editing. And if we were to like look at like two kids brains, we probably, they would look identical whether they're male or female or whatever. But if we were to look at like 10,000 brains, we might start to see on average male brains that even in sort of early childhood, male brains are slightly bigger than female brains. Some of that in part is due to larger body sizes, but not always. But bigger, you know, bigger is not always better. We know at different points in development, particularly during puberty and then also pregnancy, certain parts of the brain actually become like kind of thinner and more streamlined and lose volume as they are going through a developmental trajectory and sort of streamlining their function. So size doesn't always necessarily relate to more function when it comes to a brain.
(Bec): Yep.
0:07:57 - (Dr. Sarah McKay): We now understand that if we, you know, if we are to say, have we got a male brain and a female brain that's different, we've got to like compare apples to oranges. So we could look at, you know, like a young male lacrosse player and he's just been accepted into Harvard university and he's 18 and we could look at his brain. And then we could go to India and we could look at a woman who's just having a third pregnancy in rural India and she's like lived in quite a lot of, you know, socioeconomic poverty and she's, she's pregnant. And then we can like, you know, fly to Italy and there's, you know, a 50 year old male lawyer there who's, you know, had this lifetime of like intellectual enrichment. And then we, you know, fly to New Zealand where I grew up and we could look at someone who's 85 and in a nursing home, an older lady. And we've got all these different people that have had these extraordinarily different life experiences. We're not, we wouldn't like put the two males together and the two females together and try and see what the similarities and differences are.
So we, we must always be considering, you know, the kind of the life, you know, you, the lifespan of experiences that have shaped and sculpted your brain to whatever point. Pregnancy is going to shape and sculpt a brain, education is going to shape and sculpt a brain, socioeconomic privilege or not, gender equality or not, disease, etc, where you are in your particular sort of age ageing process, where you are in your reproductive ageing process if you're female in particular.
So it kind of almost becomes a bit silly to say, well, male brains and female brains the same or different when you look at sort of differences in development. I did post a reel on Instagram like yesterday or the day before talking about this and I think this is a really fascinating paper that almost kind of explains this. It was looking at gender equality or inequality in different countries in the world. And what we're now able to do is we're not looking at 10 brains here and 15 brains in this research lab and 100 brains, if you have a particularly good, you know, funded research project. Scientists are now like pulling data together into big biobanks so they can put all their brain imaging data together and then they're sharing that data and then scientists can kind of, you know, the more scientists are allowed to then kind of like, use that shared data… So we could, like get data from like 10,000 or 20,000 or 30,000 people's brain scans now and use not just an Excel spreadsheet and someone really clever, but we can use machine learning or artificial intelligence to analyse that data.
0:10:31 - (Bec Guild): Yeah.
0:10:31 - (Dr. Sarah McKay): And so this paper that I published, I didn't publish it was published in the journal PNAS in 2013, looked at gender equality. So it ranked countries by gender equality and then looked at male and female brain differences in terms of specific sizes of brain structures. And they found that in countries with great gender inequality, so places like, say, Turkey or India, female and male brains were more different, whereas in countries with good gender equality, like the Scandinavian countries, male and female brains are more similar.
0:11:07 - (Bec Guild): Right.
(Dr. Sarah McKay): And it's almost when there is inequality, it seems to in some way hinder the female brains following that same developmental trajectory. The male brains in countries with low gender equality were the same as male brains anywhere in the world. It's the female brains which were more different.
0:11:24 - (Bec Guild): Shaped by their experiences?
0:11:28 - (Dr. Sarah McKay): Because, yeah. And so that was like, what is causing these, this, these? It's not just this moment in time, it's this developmental trajectory that got you there. So the girls in these countries are facing more adversity and stress, less opportunities to seek education and less kind of what we might call enriched experiences. And that's altering the trajectory of their brains.
So in some countries there's more differences between male and female brains and it's not driven by sex, it's driven by gendered experiences and inequality.
0:11:54 - (Bec Guild): Yeah.
0:11:55 - (Dr. Sarah McKay): And we see the same play out. And this is what I, I was sort of looking at this data yesterday in terms of, I was speaking to a researcher who works in menopause and brain fog, and she said, you must look at incidence of dementia, not just prevalence of dementia. Because we will hear these stats. You know, women are at greater risk of dementia than men. Two out of three cases are in women, not men.
0:12:18 - (Bec Guild): Yeah.
0:12:19 - (Dr. Sarah McKay): And are we looking at prevalence? Because there's more women with dementia and old age than men, because there are more women alive? But is the incidence different? So if you look at 10,000 people in their 70s and 10,000 in their 80s and 10,000 in their 90s, is there the same incidence in these different age groups? When you're comparing males and females, and it depends where in the world you're looking.
(Bec Guild): Right.
0:12:42 - (Dr. Sarah McKay): So if you're looking in, say, European countries, really, well, wealthy, gender equal countries where there's lots of great health care, what we see is the incidence between males and females is much, much more similar. So we're not seeing massive, this massive gender gap in dementia incidents for people in their 70s. We start to see a little bit of divergence in people's 80s. So there's slightly more women. It might be like, say, 16 per thousand a year versus 12 per thousand a year, 4 per thousand difference a year in terms of new diagnoses of incidences of dementia being diagnosed in those age groups.
But if you look at other parts of the world, perhaps where there's greater socioeconomic, you know, poverty, you're seeing far more divergence there. So we have to be really, really careful when we're making these grandiose claims that we're looking at, like..
(Bec Guild): Apples for apples.
(Dr. Sarah McKay): All women and all men everywhere in the world aren't all having the same experiences and we're not seeing the same rates. Some research was looking at, it's even looked at, like, the incidence and from the… Some of the research that's been done here in Australia, so there's a big Cohort here called 45 and up, where they started looking, you know, enrolling people at age 45 and then kind of following them through the lifespan. They've got over a quarter of a million people in this study, and they're looking to see, well, when we're looking at people in their 70s and their 80s are more women than men developing dementia, and it's pretty similar, you start to see a little bit of divergence when you get into your late 80s. But it's not like it's all women and no men.
(Bec Guild): Right.
(Dr. Sarah McKay): So we've got to look at where in the lifespan, which country in the world, the kind of, the history that people are having, someone in their 80s who was, you know, a girl, you know, growing up 80 years ago, what, you know, what was kind of going on in her life versus the males in their life at that point in time. That could be very different in Australia than it might have been in India 80 years ago.
(Bec Guild): Mmmm, it’s fascinating.
0:14:55 - (Dr. Sarah McKay): So we need to be very careful with. When we're talking about sex differences, what we are looking at and not just which is kind of the current message that's on social media at the moment. Oh, it's all just, you know, every woman should be on HRT to protect themselves from dementia because that's the cause - it's menopause. The data's not necessarily supporting that there's this massive gender gap all of the time, everywhere. My point here is when we're talking about sex differences, we need to be a little bit more sophisticated in our thinking and not just…
0:15:29 - (Bec Guild): Take that 50,000 foot view instead of, yes, very low view.
0:15:32 - (Dr. Sarah McKay): Yes. A view of the earth from space would have been even better.
0:15:36 - (Bec Guild): I did note that from your book, you know, part of how you came to sort of write books or really dive into this, this aspect around the women's brain was being asked to write an article on why do women feel like they're losing their mind in menopause. And then you sort of did the deeper dive and started to go, hang on a minute. All is not how we think it is. And, you know, this is probably how you've gone through and started to weed out the subtle differences between what we think we know and what we know we know or what. Or, what we're yet to discover.
0:16:09 - (Dr. Sarah McKay): Yeah, yeah. So, yeah, I was writing for the ABC. This is back in 2015, had a, a website called ABC Active Memory. It was actually working as a, as a rec. It was like a recruitment function for a project at the Flori Institute in Melbourne. Kind of encouraging people because they were really interested in this concept of brain training. Computerised brain training was a big thing, like 10 years ago. It's not as much of a big thing now as it was then, I think, because we found it didn like, make that much difference in comparison to, you know, perhaps not sitting at your computer, but going out and being active outside or something.
But anyway, so I was writing like a weekly blog for them and we were always brainstorming new ideas and the editor said, write an article on menopause and brain fog. And I was like, I know nothing about this space, but I did know that lots of women were scared as they were going through their menopause transition. We didn't use the word perimenopause back then.
(Bec Guild): It's newer.
(Dr Sarah McKay): That they were finding their, you know, this, this concept of brain fog, which is a pretty foggy, fuzzy word of its own really. They were like, oh, I'm getting Alzheimer's disease. Is this the first sign of dementia? And it's. And it's not, but it is an experience that it's, you know, a subset of women will have as they experience this kind of phase of life.
And we used to post all the articles on Facebook, or at least the editor did. And I don't know, it had hundreds and hundreds and hundreds of comments and thousands of shares and likes. It had never.. It went like gangbusters. And I was like, that's really interesting. Clearly people are really interested. And I've actually gone through since and like, got all the comments and kind of analyzed them and there's not a single mention of the word perimenopause. It's only 2015, it's only nine years ago. It's like looking at, like ancient scripture or ancient text. You know, there's. I think there was something like six or seven people mentioned hormone therapy or HRT. So it's crazy to see how the conversation has changed. It's changed so much in nine years. But that… That was what not necessarily piqued my interest, but when I was approached to write a book, my editor or my. Sorry, my agent said, why don't you write a book on menopause? And I was like oh... And I'm glad I didn't because, well, one, I was only 40 at the time. But also, we didn't really have anything to write about when it came to the brain.
0:18:26 - (Bec Guild): Is that because there was not any research?
0:18:27 - (Dr. Sarah McKay): Yeah, there was just. There was some research on some aspects of, you know, brain health and menopause and hormones, but there wasn't a lot.
(Bec Guild): Wow. Even in 2015?
(Dr. Sarah McKay): Yeah, there was hardly any. But, you know, I think we also, I'm quite an optimist as well. We might like. The first paper that was published looking at how women's brains changed through the course of the first pregnancy, was published early, early 2017. Late sort of December, January 2016, 2017, around that sort of summer holidays. Now, the idea for that paper was in 2009 and it takes a really long time to do good science.
(Bec Guild): Yeah
(Dr. Sarah McKay): So that's.. That study was scan women's brains before and after their first pregnancy. And that was how long it takes to go from an idea, to get it funded, to set it up, to run it, to analyse the data and to get the paper published. So it doesn't mean no one was thinking about this stuff then. It's just the science takes a really long time to kind of catch up.
(Bec Guild): It hadn’t caught up yet. Yep.
(Dr. Sarah McKay): The first paper that was published looking at sort of how to broadly, how do women's brains change in structure over the course of, you know, from reproductive, you know, peak through to post menopause, they kind of came up with that idea in around 2015 and then it was published in around 2022. So it takes a really long time for research to come out. It's not like no one was doing anything. It's just that sometimes it takes a while to do good science.
But what we certainly have seen in the last five or 10 years has been enormous kind of surge of renewed interest in sex as a biological variable within kind of basic and clinical research. And then also that, you know, thinking about women's health as not a niche, but as like women's brain health in particular, as kind of a subject worthy of attention. Looking at, you know, motherhood, looking at menstrual cycle, looking at the pill. For a long time, we didn't have a lot of data. The upside is we now have all of these enormous biobanks and this data sharing and a lot of longitudinal cohort studies that are gathering a whole lot of data in. And so we can kind of go back and mine the data from that and start to ask questions of data that's now kind of in existence. And so that's kind of sort of emerging a bit more quickly now, which is quite cool and exciting. And, you know, you can go back and look at, like, a woman's reproductive history and then jump forward to, like, here's a thousand women in their 80s. What do their brains look like? What's their brain age? Is that influenced by how many children they had to be looking at them, these women in their 80s and their 20s when they were having babies? But we've got a really good detailed, you know, history, and we can analyse the brain scan data now using the new technology. So that's really exciting, I think.
0:21:16 - (Bec Guild): Absolutely. And was it that research that started to sort of put together the pieces of the puzzle in terms of seeing that there's the developmental change in that you see in adolescence and the changes in the brain in adolescence, and then also happening again through, like, pregnancies like that. And it has, like, a shaping effect on the brain.
0:21:39 - (Dr. Sarah McKay): I think the teenage brain, adolescent brain field is a little bit further ahead of some of the other work. And that comes. And that's largely due to sort of one person, Sarah Jane Blakemore, who kind of almost was the first person to say what happens to an adolescent brain?
0:21:55 - (Bec Guild):Yeah.
0:21:57 - (Dr. Sarah McKay): Because, you know, we.. it's really only been in the last 20 years, we've been able to sort of scan brains with and kind of look at what's happening inside. Before that, it was like, we look at how people's behaviour and make a guess about what's happening in their brain, or we look at a postmortem brain, or we look at what's happening in an animal in a preclinical sort of sense, in a research lab. And Sarah Jane Blakemore sort of started this sort of adolescent brain 20 years ago was when she sort of came out of her PhD and went into a postdoc work and sort of started thinking about this is a sort of a field of its own. So luckily. So that adolescent brain space is kind of a little bit further ahead than some of the other fields.
0:22:39 - (Bec Guild): But I've seen that you talk about that a lot in terms of the how, how critically important it is. And I suppose just to digress off that topic for a minute, like, this talk is about women's health, but something that's very important to women is often like, how am I going about raising my children and providing a great environment. I've seen you talk about, you know, how their brains are shaped through their experiences and their family environment, their socioeconomic environment. It's absolutely fascinating.
0:23:08 - (Dr. Sarah McKay): And we have so much good, strong data now. We've, from longitudinal studies, from all these brain imaging studies, how absolutely critical infancy and early childhood are. I mean, brains are changing the whole way through your lifespan, but in those first five years of life, your brain changes five times faster than kind of the next five, and then five times faster than like the entire rest of your lifespan. So that's when we kind of laying everything down in early infancy, in childhood, and it sets you off on a, on a certain trajectory. And we've got really clear data now about what happens in early childhood plays out not just in terms of mental health, brain development, physical health later in life. You know, if you're suffering from neglect or you're suffering from abuse or trauma in very, very early childhood, that can play out in midlife health, like thyroid function, immune function, you know, lung function, Things that you might not necessarily think there would be a direct link. People are always thinking about things like depression, but it plays out in terms of physical health.
0:24:11 - (Bec Guild): Oh, that is fascinating.
0:24:14 - (Dr. Sarah McKay): Yeah.
0:24:14 - (Bec Guild): Childhood experiences manifest in these physiological things in later life?
0:24:20 - (Dr. Sarah McKay): Yeah, and, and all of your kind of health, organ, you know, organ health. And there's very, very strong correlations between. And, you know, none of these things are kind of in isolation. We know that people have, you know, we, we can, you know, we can kind of chart that now across the lifespan. It's not like the heart is isolated from, you know, your, your endocrinology, your hormones, which is isolated from your brain. You know, we typically going to get clustering of, you know, diseases like metabolic disease and heart disease and poor brain health and dementia are going to kind of cluster together. Right? Not to say an early rough start to life will cause that, but it's certainly a strong risk factor for that. And we can see these kind of trajectories starting from, from, from ver yyoung ages. Can see trajectories of brain development into adolescence changing slightly depending on how good or bad your early start to life was.
0:25:18 - (Bec Guild): Isn't that fascinating? What other things, what other changes do we see beyond adolescence and that perhaps are influenced by hormones or even like, I think things like the, in the introduction of the oral contraceptives and some of these “fake” hormones, for want of a better word.
0:25:38 - (Dr. Sarah McKay): I wouldn't call them fake hormones. I think that's. I mean the oral contraceptive pill, the hormones are synthesised in the lab. But our, but our body and brain isn't going well. They're fake and ignoring them. Like literally they are functioning as hormones in our brain. Our brain is recognising the high levels of synthetic estradiol in the oral contraceptive pill because it's locking into the receptors and it's sort of stopping ovulation. The brain knows exactly what it is and what to do with it. It's just assuming that the levels are so high you don't need to ovulate. So I wouldn't call them fake. I think that kind of…
0:26:16 - (Bec Guild): Synthetic, external, not endogenous.
0:26:17 - (Dr. Sarah McKay): External, yeah, exogenous. Let's use that.
(Bec Guild): Yep, exogenous, that’s probably a better word.
(Dr Sarah McKay): And the pill is really interesting because, you know, we've got like sort of 60 years of use now. Women aren't dying all over the place because they've been on the pill. So, you know, I think it's pretty safe and it's, you know, an excellent form of contraception. There seems to be like this kind of shift against it at the moment as if it's somehow there's been this big cover-up that it's been damaging health. We have millions and millions and millions and millions of women globally and millions of women years, billions or women years possibly, to like kind of look at long-term health outcomes in terms of oral contraceptive use. There is a little bit of a data signal there that when girls going through puberty and adolescence start taking the pill for many different reasons, it could even be as contraception, which is a pretty good reason. That there is a slight increased risk of going on to develop depression, particularly through that kind of early adolescence, those sort of teenage years when the brain is still undergoing development and girls on the pill are slightly more vulnerable, but your absolute increased risk is not actually that high. It's going from, you know, kind of like about 4 and 100 girls to maybe 7 in 100 girls might be diagnosed with depression whether they're on or off the pill. When you're looking at women, you know, from sort of 25 onwards or 20 onwards, like adult women, we're not seeing that same increased risk. Now some people say, oh, that's kind of like, might be a survivorship bias in that when it doesn't… Women who it doesn't agree with or they don't like being on it for a lot of different reasons, they come off it. Then the women who stay on it are the ones who find it agreeable. So even if we look at those women who find it agreeable for many, many, you know, women can, like, take it continuously for 20 years, we're not necessarily seeing any negative health outcomes. In fact, there is a little bit of a data signal there to say it's possibly neuroprotective in that if we look much later in life at development of dementia, there does appear to be a slight reduced risk in women who've been taking the oral contraceptive pill for a really long time.
0:28:28 - (Bec Guild): Is that specific to a certain kind? Like, is that more likely to be progesterone version?
0:28:35 - (Dr. Sarah McKay): No, it's just the oral contraceptive pill, like, overall use. Because of course, we're looking at women, say, in their 70s and 80s. It wasn't like there was, you know, five generations of oral contraception, you know, when they were first starting to take it. So it does appear to be slightly neuroprotective in that sense. And particularly women who are taking it all the way through perimenopause and then perhaps not stopping to take it until they're entering menopause, so they're using it as a contraceptive up until that point, which is a perfectly valid reason to use it. I mean, you might not want to get pregnant, right? It's a pretty good reason to take a contraceptive. You know, we're not seeing negative health outcomes there. So I think there's a bit of a shift against it, and I'm not kind of sure where that's necessarily coming from because it's not being driven by the data.
0:29:28 - (Bec Guild): Do you think that there's a physiological problem with the, you know, given that we know that there's a lot of brain developmental changes for adolescents, that there's an issue or that there could be an issue with the fact that it kind of almost halts that natural change in hormonal maturity?
0:29:51 - (Dr. Sarah McKay): Yeah, it’s not really halting the natural change. It does appear that the… And I mean, some women choose to take the oral contraceptive pill because it flatlines like fluctuations and you've just kind of got nice high steady state of estradiol and progesterone. Like, you know.
0:30:09 - (Bec Guild): Yeah. There's a lot of groups that that’s great for, like athletes and things.
0:30:11 - (Dr. Sarah McKay): Take that for 30 years. I mean you don't need to ovulate. You could just have that really high level for 30 years. Right? Where the risk and say some women have got like that serious severe form of PMS called PMDD whereby you know, they're feeling suicidal or incredibly mentally unstable in those days before their period when hormone levels are all starting to plummet. They find that it actually helps with their emotional stability.
(Bec Guild): Yep.
(Dr Sarah McKay): And so some women are finding that it's better to be honest than to not. So we don't know why the younger… particularly the increased risk is girls who are perhaps on the pill at sort of 14 and 15, there's a slight increase in absolute risk. It's not like the pill is causing depression. It could be a develop… it could be like it's changing how the brain is going through that natural kind of pubertal development. It's not, not going through pubertal development. Girls are still developing, but perhaps it's kind of altering kind of what the brain would be expecting to be like anything menstrual cycles.
But, but I think it's important to go, well, why are those girls on the pill? And maybe they need a contraceptive and that's okay if a 14 year old's using the pill as a contraceptive because the alternative is getting pregnant and that's going to be pretty depressing if that happens, if it's an unwanted pregnancy. So I think we need to be kind of looking at not just the risks but also the benefits and try and take quite a pragmatic, data-driven approach to that.
If the girls are going on and then they are finding that it does not suit them and that, you know, like different people might have to go on a pill and then try a few different kinds out until they find one that works really well for them. That's, that's also okay. Or not go on it at all. That's also okay.
I think it's, it's, it's there and it's useful and there should be no kind of shame or stigma either way if that's the method of contraception that you choose to use. What I do have a problem with is this promotion of the idea that everyone must be naturally cycling and everyone must be ovulating and the pill is doing damage, when the data is not supporting that.
0:32:30 - (Bec Guild): You've described in pregnancy and adolescence that there's this gray matter loss. And so that's a very clear indication that there's a hormonal change kind of occurring or something that's impacting brain health. It's also, I liked that you sort of described it almost like instead of thinking like atrophy, it's like pruning a tree and things are going to grow back bigger and better or to hone in on different areas. That was what I took away from how I read that you described it. But would you like to talk to that?
0:33:02 - (Dr. Sarah McKay): Yeah. So we see similar kind of changes taking place during adolescence. Males and females, teenage boys, teenage girls, show the same trajectory of brain development during adolescence. That's almost like the pubertal hormones are opening up this kind of window of development, this kind of sensitive period of development in which the experiences you have then kind of drive the refinement of the connections in the brain. And what that looks like on a brain scan is this kind of slight loss in volume in parts of the brain, particularly the frontal lobes, that are kind of, they're the kind of the last parts of the brain to kind of go through their phase of maturation. So puberty is kind of opening up this window in which this sort of developmental sort of shift happens. And we see the volume losses due to - not due to neurons dying off, but it's due to kind of refinement of the connections which aren't needed. Slightly kind of prune and tune what you don't need. And that kind of almost results in a little sort of more streamlined version of a brain.
(Bec Guild): Yep.
0:34:05 - (Dr. Sarah McKay): And that development kind of tracks alongside the emergence of various sort of cognitive functions and skills that you see emerging in adolescence.
(Bec Guild): Yep.
(Dr Sarah McKay): Pregnancy is another kind of enormous reproductive transition because kind of one you can go through in your life. And we also see similar changes taking… not exactly the same as during adolescence, but again, we kind of see this sort of refinement and streamlining. And we see the slight volume loss. Well, not slight. It's actually quite. It's a 4% volume loss in some regions of the brain, which is. Doesn't sound like a lot, but it's enormous when it comes to a change that takes place in the brain that's not pathological, that's not caused by dementia.
0:34:45 - (Bec Guild): And I'm assuming that this is just something we notice in the transition to parenthood for females. Like, we don't see this, do we? With males?
0:34:51 - (Dr. Sarah McKay): No, we don't see it in men because they don't experience pregnancy.
(Bec Guild): Got it.
(Dr Sarah McKay): So this is due purely completely to pregnancy. And that's because the first study that was done this is by these Spanish women who kind of had this idea back in 2009. They said let's scan women who've never been pregnant before, before and after their first pregnancy. And as a control let's scan their male partners. These are all heterosexual couples. Because so the men will experience parenthood but they're not going to experience pregnancy. So it was a, you know, what's biologically the driver here? And after their first pregnancy they saw that there was a significant structural change in these women's brains. They didn't scan them during pregnancy. But we now understand most like, that it's largely driven by changes that taking place in the third trimester of pregnancy. And it's primarily those networks in the brain which are involved a lot with social cognition. So sort of empathy and theory of mind, thinking about what other people are feeling and thinking and interacting and understanding other people's needs and wants and what's kind of the thing… that who's this person that you really need to be understanding what they think and feel and need? Well, it’s like this baby that you're giving birth to. So it's kind of mother Nature's sort of preparing your, your mind and your brain for the act of motherhood and, and kind of puts your brain in this real state of kind of plasticity whereby it makes it a whole lot easier to learn how to take care of this other person.
Now fathers and the non birthing parents can still parent but it's their brains haven't been kind of primed by the hormones of pregnancy. So I suppose that the learning curve's like quite so easy or that it's quite so this is biological mandate. And of course that's because males can be there for the act of conception only and then bugger off. Their brains aren't going to change. We do see some tiny, tiny differences in the brains of dads but it's dose-dependent, and the dose being how much kind of hands-on, I hate that word hands-on fathering but how much they're actually parenting. But I mean your brain will always will change depending you're playing a lot of golf. It's going to change too. If you're gaming a lot, it's going to change too. If you're parenting a lot, it's going to change. It's quite different that change that we see compared to this significant structural reorganization we're seeing driven by pregnancy. And again it's this reduction in volume. But just like in adolescence, it's not atrophy and loss and degeneration and dysfunction, it's streamlining and refinement. And the degree of change was related to the accuracy in which mothers could recognise the emotional state and needs and wants of their baby once their baby was born.
0:37:27 - (Bec Guild): Yep. So serves perhaps to explain why, yeah, women seem to have this kind of just innate ability to be a little bit in tune with their baby..
0:37:35 - (Dr. Sarah McKay): Well, I mean, I've got a whole chapter on maternal instinct in there, because that's kind of. I think the assumption then is if you've had a pregnancy, then you're going to know what to do. And that's not, “we know what to do,” because we don't know what to do. Rather, we are in a state of it being easier to learn how to do what we need to learn how to do. We've still got to learn about our baby. We don't instinctively know from the moment they're born what they need or want, because we're like kind of social, alloparenting mammals, whereby we kind of parent in teams and in groups. So it means that, you know, we still need to learn how to do it. But you'd hope that that learning curve is a little less steep. That doesn't mean that some mothers, you know, have a baby and then, you know that there's plenty of mothers who don't take care of their children, even if they're the birth mother, and then plenty of adoptive mothers who do a brilliant job even if they didn't have a pregnancy. I think we need to be quite careful with making. Making too much meaning in terms of women and biological instinct. But there are perhaps some responses that we do see postpartum in women that are driven hormonally and maybe driven by these brain changes.
0:38:45 - (Bec Guild): Do you see trackable changes in women's brains that help to explain why some women experience postnatal depression and, or others don't?
0:38:57 - (Dr. Sarah McKay): Yeah, I mean, some women are really vulnerable to big fluctuations in hormones. And we see, you know, women who have PMDD are more vulnerable to postpartum depression and then more vulnerable during menopause. Or any kind of depression at any point in the lifespan means you're more likely the next time there's a big shift in your life, whether it be a stress or whether it be a big hormonal shift. So there are some women who are a bit more kind of biologically and emotionally and socially vulnerable.
We can't, like, scan someone's brain and go, you're going to be fine. You're not. Actually the biggest risk factor is social support or not. Not necessarily changes that take place in the brain. I think there is one thing that lots of women experience with their first pregnancy which we do know has kind of got a little bit of a biological underpinning and that's that real kind of hypervigilance that women have within those first kind of days and weeks and maybe month or two whereby they're just utterly petrified. And there's all these intrusive thoughts that something terrible is going to happen to the baby sometimes that never goes away.
(Bec Guild): Sometimes that never goes away!
0:39:56 - (Dr. Sarah McKay): Well, you, you want it to go away because you don't want it to keep interfering with your life because then that is when you need to start worrying about postnatal depression and anxiety. Like that kind of the baby's going to fall down the steps or out the window or. I remember not wanting to go into our living room because off the living room was a sunroom and off the sunroom was a, was a second floor balcony. And I was like, if I go in there, the baby will somehow fall through three rooms and off the balcony. And I had another friend who had like a tiled, like a living area, kitchen area and there's tiles in the kitchen floor and she said she stepped on the carpet at the edge of the kitchen. When I can't walk into the kitchen because I'll drop my baby on the tiles and his head will smash open. And everyone has these horrific intrusive images. And it's almost like when you've given birth and you're in this kind of state of, you know, you've gone through birth, you've had, you're just trying to figure everything out and you get in this hypervigilant state. It's almost like Mother Nature's kind of ensuring that all you're doing is keeping that baby alive. Like every cell in your body is focused on keeping that baby alive. And how it kind of manifests in our mind is of like the worst-case scenario.
And that's really, really common with the first pregnancy. Far less common with second babies because you've kind of figured it out. Like you're not, you don't think the baby's going to fall out the back of the window of the car with your second. It's only the first. But what you want says that kind of, that kind of starts to resolve. Six, seven, eight weeks, as if it persists or it gets worse, that's when women really needs be really sure that they're getting help. But no one really kind of talks about how common that is.
0:41:32 - (Bec Guild): It's interesting that is dissapates at that six to seven week mark, which is typically the time that they start sleeping for longer spells.
0:41:41 - (Dr. Sarah McKay): Like, yeah, there's a little bit of that. And I think what we see, like the kind of a comparison would be like if someone has generalised anxiety, you would kind of think it's almost as if their body's in the kind of this hypervigilant state and they're just grabbing onto the thing in front of them with which to place their work to hang their kind of worry on, like a hook. And it's almost like when you're in this kind of generalised hypervigilant postnatal state, whereby like you're biologically mandated to keep the baby alive, but you're so worried you're going to kill it, it's almost as like your mind has kind of manifested like what's the, what's the most obvious thing that's going to happen when I'm feeling in this state. It's really interesting, but we do what we do want that to dissipate. And with second babies, it's far less common because you've kind of been there and done that and you know, all these things are not going to really probably won't happen. But I like to think it's just this little trick Mother Nature has to keep your baby safe while you're figuring, while you're figuring motherhood out.
0:42:48 - (Bec Guild): So two kind of of lines of thought I have out of that. One is, and I know you've said this in your book, that during pregnancy women are a lot more, have, have less reactivity to stress. So that is a hormonal thing. And then the aspect of stress and say cortisol as a hormone also coming into the fold and its impact on the brain. So can you talk to that from your perspective.
0:43:17 - (Dr. Sarah McKay): Yeah. So we know that like biologically, when you're going through pregnancy, your cortisol levels rise quite significantly, like sort of like two or three times. It's sort of one of the hormonal changes that takes place in pregnancy. There's a whole lot of things that change, you know, you've grown an entire new enormous gland in your body, which is the placenta, which is producing, you know, it kind of takes over like massive hormone production and pumping all of this stuff into you. You've got more estrogen being pumped out of your placenta in one pregnancy than you receive in the entire rest of your lifespan combined. So you're getting this massive dose. So, you know, there's a whole lot of things going on.
But what we want is the baby not to be exposed to these extra high levels of cortisol. So one, we've got these high levels of cortisol. We want the baby to be buffered and so the placenta buffalo the baby against those high levels of cortisol, there's various kind of sort of like chemical sort of physiological buffers that, that doesn't happen. But also we don't want to be like super, super stressed and kind of super reactive simply because we're experiencing higher levels of cortisol. So there are other sort of physiological changes that take place due to lots of the other hormones that have been released. We've got like the hormone prolactin, which is just released in these kind of enormous amounts. Prolactin means pro-lactation. It's released during lactation, but also during pregnancy from the, you know, kind of primed to be released from your brain during pregnancy. We've got, you know, kind of this, this kind of enormous sort of symphony of hormones and changes.
0:45:02 - (Bec Guild): Probably more or, or more instruments in the symphony than ever.
0:45:07 - (Dr. Sarah McKay): Yeah, yeah, yeah. And one of the interesting things that we see is women are slightly less reactive to stress, which you kind of want because you don't want to be super hypervigilant. But we, we see it kind of play out quite differently sort of postnatally as well. Whereby, you know, you've lost a lot of those hormones depends whether you're breastfeeding or not. We do see, we see this in all lactating mammals. We see this kind of sort of, you know, we could call it anger or we could call it, you know, “the mama bear” response. We see this in lactating mammals whereby if their young are being threatened, they are far more likely to fight than kind of run away and hide. They're not going to like turn around and run around and hide and like leave their young there. They'll fight to protect, you know, their young if they're threatened. That idea, like never approach mother bear and her cubs is where that comes from. And human mammals, we're mammals too, we show that too. And we understand that a lot of the release of the hormones of lactation, of breastfeeding, make us… And it's actually a pro-social response. We kind of think about oxytocin being this kind of hormone of love and cuddles, but it's actually pro-social. It also gives us bravery and courage to fight and get up close and personal with someone else, which is kind of what fighting is. Right?
(Bec Guild): Right, yeah.
(Dr Sarah McKay): So you know, there's a whole lot of kind of biological changes that take place.
But I think we are humans and our brains aren't just solely driven by like hormone shifts one way or another. You know, we are also rational and we, you know, are able to kind of choose responses to and kind of think a bit more logically and kind of temper ourselves. But a lot of women in particular, and I remember this in myself was particularly surprised, and I breastfed my first son until I was pregnant with my Second who's about 14 or so months. I was like pregnant or breastfeeding like about three years, which is not actually that lots of women experience that. But anger was an emotion I'd never experienced before. I never felt angry. And part of that is just like new motherhood is really, really hard. But part of it may have been that too. And there's so much, so much shame and feeling anger, so much shame and like the emotions that you think you should feel when you're a new mum.
0:47:30 - (Bec Guild): Yes indeed.
0:47:31 - (Dr. Sarah McKay): I felt a whole lot of shame about the levels of anger I felt and part of that's just frustration because it's so hard. You don't mean to be at home by yourself with a baby all the time. And I was, my husband had a, you know, quite a full on job and we didn't have family in town. I don't know how I got through sometimes.
0:47:47 - (Bec Guild): Yeah, I had a tradesman husband so he left for 12 hours for the day and yeah, you can find it, it psychologically very confronting to be..
(Sarah McKay) Incredibly draining.
(Bec Guild): Yeah, draining is.
0:47:58 - (Dr. Sarah McKay): And like my boys were like really easy. They still are pretty straightforward, you know, they're like nearly 15 and 16 now.
0:48:06 - (Bec Guild): I definitely noticed that real calm duck on the pond aspect of being pregnant. Like just things that would normally maybe trigger me or you know, upset me or whatever. I was like, you know what? Not my circus, not my monkeys.
0:48:21 - (Dr. Sarah McKay): Whereas I felt quite, I felt quite stressed out my first pregnancy. I bled for the first three months. That was really stressful because I was like, is it going to stick? He's very tenacious even now. He did stick. But it wasn't very pleasant.
0:48:35 - (Bec Guild): No.
0:48:35 - (Dr. Sarah McKay): Every time I went to the loo I was like, am I about to start miscarriage for like the first? It was incredibly stressful.
0:48:41 - (Bec Guild): Absolutely.
0:48:42 - (Dr. Sarah McKay): I had this like kind of low-level harm of fear that whole time. And mum, my mum kept saying in very well meaning way, you know, you, it's not good for the baby to constantly be worrying. I was like. But I couldn't do anything else and I was worrying that I was worrying. I was stressed because I was stressed. It was. And had I known that normal levels of maternal angst like that don't harm the baby because the baby's buffered from your own cortisol levels, I would have been, maybe I might have, that would have been one less thing to worry about. But it was an incredibly stressful, stressful time. Luckily, once he was born he was pretty. I mean, thankfully he was very straightforward. He always has. He ate and slept and they were very straightforward boys, my two.
But me figuring out who I was as a mother, going through that process of matrescence, which was not a word that we used in 2008 and 2009 when my boys were born. Had I known that word matrescence, I would have given myself so much more grace. Because I thought, oh, I'll become a mum and I'll know what to do. I didn't realsze it was like adolescence and the brain changes are similar. You know, it's this process of becoming. And I was not very.. I did not give myself a lot of grace during that time.
0:49:55 - (Bec Guild): As I’m sure many women can understand.
0:49:56 - (Dr. Sarah McKay): Massive overachiever. I.. There's so much like social media wasn't really kind of even a thing then. I just, there's so many more messages now about what motherhood is and can be and how to make meaning of it than it was even when my boys were little. I wish I had a know and then what I know now but….
0:50:17 - (Bec Guild): The age old adage that we all say, if only we knew...
0:50:21 - (Dr. Sarah McKay): Yeah, yeah, I'm glad I did what I did because my goal was to... I really wanted to not be checking in and checking out and dropping in and dropping off and I just wanted to have like a really like, I just wanted them to have like this priest, like we live by the beach, just have this calm, gentle, go to playgroups in preschool and the beach and mother's group and the park and not go anywhere. And I wanted all of that and I tried to create that. It was really hard. I don't think I had unrealistic expectations, but I was quite determined as to what sort of childhood I was going to give them based on the childhood my mum gave me.
0:50:59 - (Bec Guild): And also your knowledge of how important that is to shape their brain.
0:51:03 - (Dr. Sarah McKay): Yeah, I wasn't really thinking about their brains to be perfectly honest.
(Bec Guild): But you are now?
(Dr Sarah McKay): It was a bit more idealistic than that, I think. But I'M really glad I was so determined because it was very hard at times, but everyone finds motherhood very hard. But I found it very hard. I found myself very hard. But gosh, I'm glad I did that now. I look back on that and go, oh, gosh, that was tough. Oh, we did, we did it. Wow. And now like, you know, now my oldest is talking about where he might go away to university and you're like in the blink of an eye.
0:51:36 - (Bec Guild): Yep. The beauty of motherhood.
0:51:38 - (Dr. Sarah McKay): Yeah.
0:51:38 - (Bec Guild): Well, as I guess a bit of a final wrap-up question because I'm conscious I've taken a lot of your time, I guess, just to wrap up, like from your own kind of neuroscience perspective, what do you think are the, the absolute most important things that everyone could do to keep their brain agile and as healthy as possible? Like what have you seen from the evidence?
0:52:01 - (Dr. Sarah McKay): So, well, the Lancet in partnership with Alzheimer's association recently just put out the sort of the 14 modifiable risk factors which might help sort of reduce dementia around the world. So there's kind of that in there which, you know, gives you kind of a long term health perspective, which is around having a good start to life, early education for kids and then at midlife, weirdly, hormones are not on there. I don't know, maybe, you know, they're one little voice in the crowd. We've got things in there which people completely don't pay any attention to, like hearing loss. Because if you can't hear, you can't interact, you can't communicate, you can't socialise, your world becomes very, very small. That's not very, that's not very healthy.
We've got a lot of factors in there around kind of metabolic cardiovascular health, you know, like exercising and not being overweight and not drinking too much alcohol and making sure your cholesterol is under check and your blood pressure, etc. Avoiding head injuries. We don't want to be having like multiple concussions. Like what we're sort of starting to see emerge from a lot of the professional collision sports. So there's a lot of those midlife factors in there. And then like longer term, you know, you know, ageing down the track, we've got, you know, and then there's things like air pollution as well, which is not necessarily modifiable risk factor, but we could kind, kind of, that's more of a kind of public policy level type change..
(Bec Guild): Something to be mindful of anyway.
(Dr Sarah McKay) Something you, you can do yourself, you can live somewhere with fresh air, but again, that's a wealth/privilege type thing. And then in old age is things like social engagement and you know, vision loss. So again being able to kind of interact with the world, that's kind of like taking a long-term perspective of dementia risk reduction. And I think it's interesting there because there's not really necessarily like this sort of the sex difference data in there falling out really, really clearly, which is what a lot of the messaging, especially if you’re like I am 49, what your social media algorithms are feeding you, it's like HRT or dementia.
(Bec Guild): Yep.
0:54:04 - (Dr. Sarah McKay): That's not the message at this point in time that may be down the track, but right now we don't have data to support that. But I think like kind of short term, like day to day. Like I, the absolute most important thing I do is sleep. Like I am so selfish about my sleep and it's so good having teenagers because you just go to bed and you don’t have to worry about them anymore. And I am, I've always been really precious and protective around my sleep and I love my sleep and I nap a lot.
0:54:35 - (Bec Guild): Okay.
0:54:36 - (Dr. Sarah McKay): If you haven't got your sleep sorted, if you haven't got good sleep, then of course you're going to have emotional instability and brain fog. Like your cognitive function and your emotional function and your overall physical health and well-being. Like if you haven't got a foundation of sleep, you can't build all of the other things on top.
0:54:52 - (Bec Guild): Indeed.
0:54:53 - (Dr. Sarah McKay): That doesn't not mean, I mean still like if you, if you haven't got good night's sleep, you haven't got anything. Yeah. And then the other things are I just have this funny group of like, lots of different groups of friends. Like I've got like my neighbours and I've got like my book club and I've got like my like girls that I like do musical theatre with and do dance with and I've just like got my really old friends and I've just got like so many good female friends and we just, and none of us really take ourselves seriously. Like I think you have to have like a group of self-deprecating, hilarious female friends that you can just laugh with and at and just have a really good time with.
And then my final ingredient is like the sea, the ocean. I'm looking out at the beach at the moment. I like just surfing and swimming and sailing and that's yeah, that's yeah, they’re the things that I think.
(Bec Guild): Yeah, time in nature, sleep, connections.
0:55:53 - (Dr. Sarah McKay): Maybe not sharks are everyone’s thing.
(Bec Guild): Not my thing.
(Dr Sarah McKay): But all my WhatsApp groups now like of all the ocean swimming crowd. And even at my dance class the other night, the girls like, oh, there's loads of, there's loads of PJs and we're all like swimming towards the shark sucks. But they're harmless, these ones. So those, those, those like I think and I have got such a fortunate, wonderful, happy life right now. And I only hear like horrible stories, like I'm 49, I'm turning 50 in January and you would think that this is the worst sort of time of life based on what the algorithm's feeding. And I can't wait until I turn 50. I'm going to have like a gap year. I’m just going to have so much fun, you know, like every single day is the good old days.
0:56:41 - (Bec Guild): Yeah. I don't think that there's as much doom and gloom about being 40 as is made out to be. And not, you know, I'm at the front end of 40, but 42. But yeah, it's, it's. I remember actually reading an interview from, of all people, Jennifer Aniston, once upon a time talking about aging and how she felt, felt much more secure as in herself and much more confident and much more kind with herself in her sort of 40s as she was back to her, the person she was in her 20s or even her 30s. So I always thought that was a really interesting observation.
0:57:15 - (Dr. Sarah McKay): Yeah, I think, yeah. Just don't take it so seriously.
0:57:20 - (Bec Guild): No, great advice.
0:57:22 - (Dr. Sarah McKay): I've had friends, you know, one of my oldest friends shout out to you, Kelly Hutton. I went through, I was at Kindy with her. I've known her since I was 4. She died a year ago from ovarian cancer. And I went right through Kindy primary and high school with her. And you know, like, you know, you shouldn't get to see 50, and that sucks and I do. So..
(Bec Guild): It’s a privilege denied to many.
(Dr Sarah McKay): Absolutely make the most of it. Yeah, yeah.
0:57:54 - (Bec Guild): I say that about my gray hair. It's a privilege denied to many. I'm just going to embrace it.
0:57:59 - (Dr. Sarah McKay): 100%, yeah, so is, so is.
0:58:01 - (Bec Guild): Well, on that note, thank you so very much for joining me for this chat to talk about all these wonderful nuances around women's health and also to get those perspectives on, you know, that like we talked about at the beginning, like that 500 foot view or the view from space. Sometimes we can get bogged down in the nitty gritty of it, can't we?
0:58:20 - (Dr. Sarah McKay): Yeah, I think we can. I think we can.
0:58:23 - (Bec Guild): Yeah.
0:58:23 - (Dr. Sarah McKay): And I like the data. You know, that's.. That's the stories that I'm choosing to tune into because I think they're sometimes a bit more positive than what people think.
0:58:32 - (Bec Guild): Agreed. Well, thank you so much. I will look forward to seeing your next book, which I was reading. This is going to be. Yeah.
0:58:41 - (Dr. Sarah McKay): Oh, well, the woman's book. Yeah. So my first book is. Yeah, I'm doing it. I'm doing. I'm doing a 2025 second-edition update. So lots of it is completely, completely getting rewritten. Some of it's. Some of it's the same. Some of it's just getting new bits of info added in here and there.
0:58:56 - (Bec Guild): Just evidence of how quickly the science changes. Right. Or…
0:58:59 - (Dr. Sarah McKay): Yeah, it's very, it's very cool. Yeah, it's very cool. It's more. It's much nicer editing an existing book. I wrote another, first half of this year I spent writing Brain Health for Dummies.
0:59:10 - (Bec Guild): That's the one I was like, it's coming out soon, right?
0:59:13 - (Dr. Sarah McKay): That's coming out the 1st of January next year. But I'm just doing, going through all of the edits and stuff like that. So that comes out. And then the Women's Brain book, I'm also updating for a second edition. So that's, that's very exciting too.
0:59:28 - (Bec Guild): Well, I'll make sure we pop all the links so people can find them because I'm sure, yeah, they'll be interested.
0:59:32 - (Dr. Sarah McKay): Yeah, you can pre-order Brain Health for Dummies now.
(Bec Guild): Perfect.
EPISODE RESOURCES:
Find Dr Sarah McKay via her website www.drsarahmckay.com
Find Dr Sarah McKay's Books here: www.drsarahmckay.com/books