Menopause Brain Doctor

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, sexual 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.

08/14/2026

08/03/2026

This is Judy's story...

From fear to action

From worrying to empowered

From a diagnosis to leaving the diagnosis behind in the dust

Judy was diagnosed with Alzhiemer's dementia at 67. Her mother had succumbed to the disease some years prior.

Judy was certain she did not want that to be her future.

So she took action.

She implemented the ReCODE 2.0 protocol created by Dr. Dale Bredesen, MD, the basis of the Aruna Stay Sharp™ Program.

Join me on Wed, Aug 5th, at 12 pm for a free online masterclass on how I help women with a family history of dementia protect their own brain health.

Register here: https://arunamed.com/masterclass

Bring your questions.

I look forward to seeing you there.

Alzheimer’s Survivor Walking Across England

Patient Zero—Judy Benjamin—who is now 82, over 14 years on the ReCODE protocol, and continuing to do very well, recently completed a 2700-mile walk from the Pacific Ocean to the Atlantic Ocean. Today she begins a new journey in England, a 650-mile trek that includes walking from Land’s End to Dover, Canterbury, and then London. Judy founded the Alzheimer’s Survivors Foundation to bring awareness to the many survivors around the world—as the survivors say, “Alzheimer’s Survivors—We Exist.” Congratulations, Judy, on your remarkable accomplishments that are helping to reduce the global burden of dementia. Good luck on the walk!

07/17/2026

Fear keeps so many women from having the brain health conversation they need to have 🧠💜

I hear it all the time.

“What if it’s genetic?”
“What if I can’t do anything about it?”
“What if I find something I don’t want to know?”

Fear feels real, but it should never be the reason you stop seeking answers.

07/15/2026

Some of the biggest menopause brain myths leave women feeling powerless 🔬🧠

I regularly meet women who believe they have to live with brain fog, that a family history of dementia determines their future, or that losing their sharpness is simply part of aging.

The truth is that brain health is influenced by many factors, and understanding those factors gives you the opportunity to take action earlier and more effectively.

07/13/2026

If dementia runs in your family, I want you to pay attention, not panic 🧠💜

Midlife is one of the most important opportunities to support your future brain health because the brain can still adapt and change.

Family history matters, but it is only one part of your story.

Comment BRAIN and I’ll send you my free Brain Health Assessment.