Estrogen vs. Progesterone: Why Women Need Both for Brain Protection | Sarah Hill

0:01Sarah Hill:This is a Be Well Moment, the most replayed moments from my latest conversation. It's a glimpse into the wider episode, which you can find linked in the show notes below. Because sometimes one small moment is enough to reconnect to living well and being well.

0:22Sarah Hill:I actually wanted to start this like whole conversation with something that maybe I I resonate with a lot, but also a lot of women in my life say this, that they feel two different sets of people across the month. And I then think, well, you know, we want to try and trust our decisions as women. I think we're quite intuitive as women. How do we learn to trust ourselves when the internal narrative shifts a lot between the month?

0:45Sarah Ann Macklin:I mean, I think that it's like having two wise advisors, you know, and so that there's wisdom to be gleaned from each. And that, you know, when we actually recognize that there is wisdom in each of these phases of the cycle and that as we shift between one, you know, one phase of the cycle to the other phase of the cycle and as our hormones change, that this does change our brain, you know, and because of that, of course, we're going to feel a little bit different. And when we understand that this is happening on purpose, right, and that these shifts that we have have a really important set of functions within our body and like lean into really trusting the way that we're experiencing the world during these times I think that we can sit back and really treat these two halves as being like two trusted advisors and thinking about you know looking at things from multiple perspectives I think it makes us better decision makers

1:39Sarah Hill:yeah I love that I think women should be making more decisions anyway yeah the world will be a better place. So you mentioned there about two different phases of the cycle. Now you have focused a lot on the second phase, which is the luteal phase, which you also called the dark side of the cycle. Yes. Quite mysterious.

1:56Sarah Ann Macklin:I know. Well, you know, the reason I called the dark side of the cycle or the dark half of the cycle is because nobody talks about it, you know? And so it's like, there's all, you know, and if you look on social media or you listen to podcasts, there's a lot of talk about estrogen, a lot of talk about ovulation, a lot of talk about fertility, and it's all about what's happening in the fertile phase of the cycle. And there's no discussion about what happens in the second half. Like people don't think about progesterone as being an important hormone when it's our second primary sex hormone. And it's just as important as estrogen, just in terms of shaping the way that our body and brains respond to everything.

2:36Sarah Ann Macklin:And so it's like dark in that a lot of women kind of feel bad during this time, right? We tend to have less energy. We tend to be sleepier. We tend to have more sort of emotional sensitivity. And it's also not discussed. And so like women are like, okay, I understand myself. And there's estrogen and, you know, infertility and sexual desire. And I feel all these things. And then, you know, boom. And then there's nothing. They're told nothing about what happens in the second half of the cycle. They're not told why they have the experiences that they have. And they're also not told that progesterone is an important hormone.

3:09Sarah Ann Macklin:And, you know, one of the things that's been so eye-opening for me is, you know, so I'm a scientist. I've been a research scientist for 25 years now. And so, you know, whenever I've approached hormones, it's always been sort of as a research question in terms of the way that they influence the brain and then the way that they influence motivational states and behavior. I'm not a physician. And so when I talk to physicians and understand like the way that they treat women's sex hormones, and especially when I'm talking to physicians that treat women who are going into the menopausal transition and paramenopause, a lot of them, when they're giving women hormone therapy, only will give them progesterone if they have a uterus.

3:53Sarah Ann Macklin:with the idea that the only function that progesterone serves is thinning the lining of the endometrium. And to me, that's just like totally crazy that, you know, that we think that estrogen does all these things for the brain and it's, you know, neuroprotective and then progesterone only affects the uterus. I mean, it's just simply not true. And so, you know, just to highlight one of the reasons that I really focus on the luteal phase and progesterone is progesterone is neuroprotective. It has these really beautiful anti-excitotoxic effects in the brain, which just means that it prevents the brain from getting so excited that it actually can create damage within the brain, like brain damage from being overly excited.

4:39Sarah Ann Macklin:And so just to give an example, somebody who has a concussion or has some sort of a traumatic brain injury, one of the first medications that they give people is progesterone. And they do this because it slows down firing in the brain and can prevent it from over firing and actually harming itself from too much excitability. Because too much, I mean, it's like everything poison is always all about the dose. And, you know, having a lot of, you know, having your brain firing makes you feel smart and on top of things. And estrogen does this and it makes us feel like yes, yes, yes. But too much of that isn't a good thing, right?

5:14Sarah Ann Macklin:It's all about having the balance and giving the brain an opportunity to slow down. And so that way it doesn't create problems for itself. And, you know, when you look at the way that hormones are being explored for being protective against things like Alzheimer's disease, they're starting to really understand the role of estrogen and being protective there. Nobody's even looking at progesterone, even though it has, you know, they've been using it for traumatic, like to protect the brain and traumatic brain injury for years. but nobody's ever thought like hey you know this might also be really important like in terms of neuroprotection for a woman with a cycle and then exploring that as a potential mechanism for protection against Alzheimer's disease.

6:07Sarah Hill:Thank you for listening to this Be Well Moment. If it resonated the full conversation is linked in the show notes and I hope it gave you a small pause to take a moment for you and to reconnect to living well and being well. If you loved it, please do leave a review, follow the show or share this maybe with someone you love.