Why Do We Ignore Women’s Brain Health?
What do hormonal changes really do to the brain? In many ways, we still don’t fully know.
For decades, neuroscience has largely overlooked this question. It’s tempting to attribute the gap to plain old sexism and while that’s certainly a factor, the issue runs deeper. The reality is that the female brain is complex. It operates within a dynamic hormonal rhythm that shifts week to week and across life stages, from puberty to pregnancy to menopause. Yet instead of embracing this complexity, science often treated it as a glitch in the system.
Rather than asking why the brain changes in response to hormonal fluctuations, researchers spent years trying to control or eliminate that variability. Hormones were viewed as confounding factors. They were too messy, too unpredictable. As a result, women were excluded from clinical trials for much of the 20th century. Even after policy changes in the 1990s mandated their inclusion, many studies still failed to collect critical information like menstrual cycle phase, hormonal contraceptive use, pregnancy history, or menopausal status.
Not surprisingly, the data from early neuroimaging studies was often contradictory or misleading. Findings focused on surface-level differences, whose brain was “bigger,” or whether women were “hard-wired” for empathy, rather than producing meaningful insight into how hormones shape cognition, emotion, or health outcomes. Much of this research reinforced stereotypes rather than challenged them. The term neurosexism emerged in response: a critique of scientific claims that exaggerated or distorted gender differences under the guise of objectivity.
That critique is valid. Neuroimaging has absolutely been misused to bolster outdated assumptions about gender. But it’s equally important not to swing too far in the other direction. Studying hormonal effects on the brain isn’t a distraction, it’s essential. While researchers argued over “pink” versus “blue” brains, real people were navigating hormone-related disorders like PMDD and PCOS with little scientific understanding or support. Experiences such as mood swings, brain fog, fatigue, and emotional dysregulation were often dismissed with a wave: “It’s just hormones.”
But hormones aren’t peripheral. They’re central to brain function.
Estrogen and progesterone don’t only regulate reproductive cycles; they influence neurotransmitters like serotonin and dopamine, modulate inflammation, and even affect brain structure. Their fluctuations shape mood, memory, metabolism, and cognition. Ignoring hormones in brain research is like trying to understand the ocean without accounting for the tides.
Science has long treated hormonal variability as instability instead of what it actually is: adaptability. Women’s brains are designed to change. They’re responsive to life phases: puberty, pregnancy, menopause, the monthly cycle. That is not a design flaw. That’s neuroplasticity doing exactly what it’s supposed to do, and it’s one of the most fascinating and underappreciated aspects of brain science.
Yet even today, conditions like PMDD and PCOS remain under-researched in neuroscience. Postpartum depression, a condition affecting a significant number of new parents, is still poorly understood, despite widespread agreement that hormonal shifts likely play a role. The prevailing solution across many of these disorders has often been to “flatten” hormones altogether, most commonly through hormonal birth control. While helpful for some, this approach is often prescribed without addressing root causes or considering long-term brain effects.
Fortunately, the field is beginning to evolve. Large-scale neuroimaging studies are mapping how estrogen affects memory and brain connectivity. Researchers are documenting how pregnancy remodels brain architecture, including reductions in gray matter volume and changes in cortical thickness, and how menopause influences cognitive function. Crucially, these studies are starting to center hormonal status, life stages, and the lived experiences of women and menstruating individuals.
Innovation is also emerging outside traditional research. A new generation of femtech products, ranging from hormone-tracking wearables to digital health tools for perimenopause and brain-based therapies for PCOS or postpartum mood disorders, is stepping in to fill the void left by conventional healthcare. While these tools raise important questions about access, privacy, and efficacy, they represent a long-overdue effort to integrate hormonal and cognitive health.
Still, we remain constrained by a system not built with women in mind. Most clinicians receive little training in how hormonal changes intersect with neurological symptoms. Insurance rarely covers comprehensive, integrative care. And clinical research continues to underrepresent women of color, neurodivergent individuals, and anyone who doesn’t fit the “standard” research profile.
If we are serious about improving mental health, cognitive well-being, and equitable care, we must stop treating hormonal biology as an inconvenience. The female brain is not a deviation from the norm, it is the norm for half the global population. It is responsive. It is adaptable. And it deserves to be understood on its own terms.
