Menopause Brain Doctor

09/08/2026

09/07/2026

You have the lab results.

But do you actually know what they’re telling you?

“Everything looks fine” is not the same as understanding your health.

Your lab report contains information about your metabolic health, cardiovascular risk, hormones, thyroid, inflammation, nutrient status, brain health and more. And some of the most useful numbers are ones many women have never been taught to understand.

That’s why I created the Early Advantage Masterclass: 10 Biomarkers Every Midlife Woman Should Understand.

Come spend 90 minutes with me.

Bring your latest labs. Follow along as I walk you through 10 biomarkers I want midlife women to understand. See where your own numbers fall. And bring your questions.

My goal isn’t to turn you into your own doctor.

It’s to make you a much better-informed health consumer—someone who knows what questions to ask, what deserves a closer look, and when “your labs are fine” may not be the end of the conversation.

And please don’t outsource all of that thinking to AI, either.

AI can explain a lab value. Your doctor can interpret a lab value.

But you should understand your own health well enough to participate intelligently in the decisions being made about your body.

Your labs belong to you.

Learn how to use them.

Early Advantage Masterclass
90 minutes | Bring your labs | Bring your questions

Link in bio.

09/06/2026

Beyond Vaginal Dryness and Genito-Urinary- Syndrome of Menopause (GSM).

Here are the two main questions I ask women about s*xual health: do you want s*x, and can you have it comfortably?

If no and you’re at peace with it, we are done.

If something’s blocking desire or causing pain, both are treatable — though progress can be slow and partial, and that’s still worth it.

Your s*xual life is yours to decide what to do with.

Beyond Vaginal Dryness and Genito-Urinary- Syndrome of Menopause (GSM) TLDR: Two questions: do you want s*x, and can you have it comfortably? If no and you're at peace with it, done. If

09/06/2026

You’re still working, still managing the calendar, the family, the deadlines, the thousand things that make up your life.

And nobody else can tell.

But you can.

You’re searching for words. Losing your train of thought. Working harder to stay focused. Forgetting things that used to come easily. Your brain just doesn’t feel quite like your brain anymore.

There’s actually a term for this: subjective cognitive decline—when you notice a change in your cognitive function even though it may not yet show up clearly on standard testing or be obvious to the people around you.

This is not the time to panic.

It’s the time to pay attention.

Because there are many potentially modifiable contributors to cognitive symptoms in midlife—from hormonal changes, sleep and stress to metabolic and vascular health, nutrient status, medications and more.

And this is exactly when I want to start asking why.

In my work, I incorporate principles from Dr. Dale Bredesen’s ReCODE approach to look systematically for factors that may be affecting brain health and identify what we can address now.

You can also take a brain health assessment to learn more about your current risk factors. Find information about the brain assessment through the link in my bio.

Don’t wait until everyone else can see the change you already feel.

Your earliest signal may be your greatest opportunity to act.

09/05/2026

Before you quit the job—or the relationship—give me six months.

Not because the job isn’t wrong.
Not because the relationship isn’t wrong.

But because in midlife, your brain and body are changing too.

Sleep gets disrupted. Stress tolerance drops. Cognitive bandwidth shrinks. Things you once handled easily can suddenly feel unbearable. You may feel less resilient, less confident, less like yourself—and start wondering whether your entire life needs to change.

Maybe it does.

But before you make a permanent decision, make sure you’re making it from a brain and body that are adequately supported.

Address the hormones. Restore the sleep. Rebuild the energy. Expand the bandwidth.

Then look at the job again.
Look at the relationship again.

And if you still want to leave?

Leave.

But make the decision from clarity—not depletion.

09/04/2026

Before you quit your job—or your relationship—consider what else may be changing.

Midlife can affect far more than your hormones. Sleep, mood, energy, metabolism, cognition, s*xual health, stress tolerance, and your overall bandwidth can all shift.

That doesn’t mean the problem is “just menopause.” Your job may actually be wrong for you. Your relationship may need to change.

But before you make a major decision, it helps to understand what’s happening inside you as well as what’s happening around you.

Give yourself the chance to make the decision from strength rather than depletion.

Take the Menopause Health Assessment and get a clearer picture of where you stand and what deserves your attention.

08/31/2026

“HRT reduces dementia risk by 10%.”

It sounds like great news—but the devil is always in the details.

In this large UK Biobank observational study, menopausal hormone therapy was associated with approximately:

• 10% lower overall dementia incidence
• 26% lower dementia incidence among women with early surgical menopause
• 13% lower incidence among women carrying APOE ε4

But here is the finding most headlines will miss: among women who experienced natural menopause, hormone therapy was not associated with a statistically significant overall reduction in dementia.

That is puzzling.

One possible explanation is that replacing hormones after the abrupt loss of ovarian function helps mitigate the additional neurological risk created by surgical menopause. But the study does not explain why no significant benefit appeared in the larger group of women experiencing natural menopause.

More importantly, this observational study cannot tell us which hormone regimen might support brain health. It lacks the clinical detail we would need about the hormones used, their formulations, doses, routes, timing and duration. It also cannot establish causation.

Some will interpret these limitations to mean that the study does not justify using HRT to prevent dementia—and it certainly does not prove that hormone therapy prevents dementia.

But that is not how I use HRT.

In the ReCODE approach, hormone optimization is one of the foundational building blocks we consider when addressing the multiple systems that influence long-term brain health. It is not a stand-alone dementia-prevention treatment, and it is never the whole strategy.

I will therefore continue the approach I have used for years: advocate for HRT based on the individual woman in front of me, begin as early as possible during perimenopause when clinically appropriate, continue for as long as possible when the benefits continue to outweigh her individual risks, and adjust the formulation and dosage according to her symptoms, history, response and goals.

The headline is simple. The science—and the woman—is not.

For more details, see the links in my bio.

08/28/2026

If you’ve watched your mother or father or another loved one lose their memory, I don’t need to tell you why brain health matters.
You already know.
Maybe you are the daughter who went to the appointments.
Maybe you became the caregiver.

Yu’re living your own life.
You have a career. People who depend on you. Relationships you care about. Things you still want to do.
But there’s a question somewhere in the back of your mind:

What can I do for my own brain?

I want you to know that family history is important—but it is not the only thing I want to understand about you.
When I think about your brain health, I want to look at the bigger picture.
Your sleep. Your metabolic health. Your cardiovascular health. Your hormones. Your mood. Your exposures to environmental toxins. Your medical and family history. And the changes you might already be noticing.

There are things about our genetics we cannot change.

But there are many things about our health that we can.

I’m Dr. Manna. I trained in Dr. Dale Bredesen’s precision medicine program for the reversal of cognitive decline, and I’ve been working with women on brain health for many years.

I created the Brain Health Assessment to get a sense of where things are for women like you.

It takes just a few minutes to complete. I review your responses and send you my thoughts about what stands out to me.

It’s complimentary, from me to you.

If you’ve watched someone you love go through this and you’ve been wondering what you should be thinking about for yourself—
start here.

Take the assessment, and I’ll share my thoughts within two days.

Send me a DM with questions.

Link to assessment in comments.

08/26/2026

What a wonderful conversation with Mandy Gallagher of the AICPA. This was a preview of my upcoming keynote at their annual women’s conference in San Diego in November.