Understanding Your Brain Through Perimenopause and Menopause with Dr. Louisa Nicola

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Feb 3, 2026

Louisa Nicola, neurophysiologist, Alzheimer’s researcher and former world-class triathlete, studies how sleep, hormones and exercise shape women’s brains. She explains how Alzheimer’s pathology builds decades early. Short segments cover hormone loss in perimenopause, sleep’s role clearing proteins, why women are at higher risk, and how resistance training, nutrition, and timely hormone strategies may help.

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INSIGHT

Women Bear Most Alzheimer’s Burden

Women represent about 70% of Alzheimer's cases, so sex-specific factors matter deeply.
Lifestyle and modifiable factors explain most cases, giving women agency to reduce risk.

ADVICE

Protect Your Brain With Deep Sleep

Prioritize sleep because it activates the glymphatic system that clears amyloid beta each night.
Aim for consistent deep sleep to support nightly clearance and reduce long-term buildup.

INSIGHT

Amyloid Isn't The Whole Story

Amyloid beta can be protective, released to shield neurons under stress rather than purely toxic.
Tau hyperphosphorylation (driven by GSK3β) and estrogen loss during perimenopause increase women's tau vulnerability.

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An estimated 7.2 million Americans age 65 and older are currently living with Alzheimer's dementia. The part that should alarm every woman listening is this: almost two thirds of them are women.

In this episode, Dr. Mary Claire Haver sits down with neurophysiologist and Alzheimer's researcher Dr. Louisa Nicola to unpack what's really happening to women's brains during perimenopause and menopause and what we can do about it. Louisa Nicola is a neurophysiologist, human performance coach, and founder of Neuro Athletics, a consulting firm that works with elite athletes and high-level professionals to optimize brain health and performance. A former world class triathlete, she transitioned into neuroscience and earned her Master of Medicine in neurophysiology from the University of Sydney. Dr. Nicola is currently pursuing her doctorate studying the effects of resistance exercise on brain health. She focuses on optimizing brain function and longevity, particularly in women, through sleep, nutrition, and exercise interventions.

Dr. Nicola reveals how Alzheimer's disease doesn't suddenly appear at 70 but starts quietly in our thirties and forties, building up over a 30-year progression. She explains what's happening in the brain as amyloid beta proteins and tau tangles accumulate, why the hippocampus is the first area to go, and the critical role that sleep plays in clearing these proteins through the glymphatic system. The conversation explores why women are more predisposed to tau protein accumulation than men and how estrogen, progesterone, and prolactin inhibit the enzyme that causes tau proteins to become hyperphosphorylated and toxic. Dr. Nicola explains the connection between declining estrogen during perimenopause and increased Alzheimer's risk, including how estrogen helps mediate glucose metabolism in the brain, supports synaptic connections, and why the loss of this hormonal scaffolding leaves women vulnerable to cognitive decline.

Guest links:

Louisa Nicola (Instagram)

Louisa Nicola (Facebook)

Louisa Nicola, MMed, PhD(c) (LinkedIn)

Louisa Nicola (YouTube)

Louisa Nicola (X)

Neuro Athletics

The Neuro Experience Podcast (Apple Podcasts)

The Brain Code

Books
“Joyspan,” by Dr. Kerry Burnight
“The New Perimenopause,”⁠ by Dr. Mary Claire Haver

⁠"The New Menopause"⁠ by Dr. Mary Claire Haver

For full show notes, please click here.

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