Rethinking women's brain health across the lifespan: the power to change

Despite remarkable advances in neuroscience, women’s brain health remains strikingly understudied. Yet hormonal transitions across the female lifespan offer unique opportunities to understand one of the brain’s most remarkable capacities: its ability to change. In this plenary lecture, Professor Julia Sacher will challenge traditional approaches to studying women’s brain health, moving beyond a predominant focus on hormonal vulnerability towards a deeper understanding of neuroplasticity, adaptation and resilience. Drawing on multimodal neuroimaging research, she will highlight three complementary approaches. First, molecular imaging studies of postpartum depression reveal how rapid hormonal changes interact with neurotransmitter systems, offering new opportunities for targeted interventions. Second, dense longitudinal sampling across the menstrual cycle demonstrates how individual hormonal trajectories shape brain structure, serotonergic signalling and brain–body interactions, with implications for understanding premenstrual dysphoric disorder and developing precision treatments. Third, large-scale, sex- and gender-sensitive cohorts reveal how endocrine, metabolic and vascular processes intersect to influence brain health, particularly during the perimenopausal transition. Together, these findings challenge the notion of the adult brain as a relatively static organ and demonstrate why hormonal variability should be understood not simply as a source of noise, but as a valuable biological signal. Professor Sacher will conclude by outlining how integrating mechanistic neuroscience, individual trajectories and more inclusive research designs can transform women’s brain health research, advance personalised prevention and treatment, and ultimately improve care across the lifespan.