August 29, 2026

@michaelokun

What resonates most with me in this important Nature Reviews Neurology roadmap from Bove and Dobson is the argument that menopause should be viewed not simply as a reproductive event, but as a potentially important neurological transition across the lifespan. We have historically studied diseases such as Parkinson’s, Alzheimer’s, MS, migraine and epilepsy without adequately asking how reproductive aging and changing hormonal biology might alter symptoms, resilience, disease risk or response to treatment. Remarkably, about two-thirds of women report cognitive concerns during the menopausal transition, yet we still have major gaps in understanding what these changes mean for future brain health. Particularly provocative are observations linking earlier or surgical menopause with later Alzheimer’s disease and Parkinson’s disease risk, although association is not causation and we need to resist jumping prematurely from epidemiology to hormone-based treatment recommendations. What I especially like about this roadmap is where it points us next: longitudinal human cohorts, imaging, biomarkers, multi-omics, careful study of modifiable midlife factors, and inclusion of reproductive-aging measures in neurological trials. Women’s brain health should not be a niche within neurology. It should be embedded into how we study, prevent, diagnose and treat neurological disease across the lifespan. https://www.nature.com/articles/s41582-026-01244-5