A Precision Medicine Guide to Menopause Brain Fog vs True Cognitive Decline Often associated with temporary difficulty Red Flags, worth discussing promptly Earlier this year, a lovely and emotional 65-year-old attorney sat across from me, in my San Diego, southern…
TL;DR: Direct-to-consumer lab testing is booming because it gives people fast access, autonomy, and answers when traditional healthcare feels slow or dismissive. But getting biomarkers is not the same as getting healthcare. Labs without clinical context, reasoning, and a treatment…
TL;DR: Every night you sleep through a hot flash, your heart is on high alert, your blood pressure spikes, and blood flow to your brain is transiently reduced. Over time, in women with frequent nocturnal hot flashes, these events leave…
I wrote this manifesto in the early drafts of my book. I didn’t plan it. It arrived fully formed, all at once, the way things arrive when you have been holding them inside for too long. It came from years…
TL;DR – Subjective symptoms cannot distinguish between reversible stress, hormonal disruption, or early neurobiological risk. Blood-based brain biomarkers can. Markers such as pTau-217, GFAP, and NfL reveal amyloid activity, neuroinflammation, and neuronal stress that symptoms alone cannot access. For women…
TL; DR – If men lost testosterone the way women lose estrogen, it would be treated as a medical emergency, not a “life stage.” Men’s testosterone declines gradually and partially over decades. Women’s estradiol loss at menopause is abrupt, near-complete,…
TL;DR: A new Alzheimer’s trial achieved what no previous trial has — every treated patient improved. The secret wasn’t a drug. It was addressing the full picture: metabolism, inflammation, sleep, hormones, toxins. Every woman in the study received hormone therapy…
TL;DR: The most consequential organs for you to understand in your body are your ovaries. They aren’t just egg storage and monthly cycles — they produce hormones that run your brain, heart, bones, mood, and sleep. They’re the only organ…
A randomized controlled trial validates what I’ve seen in my practice: cognitive decline doesn’t have to be inevitable. TL; DR – A randomized controlled trial published December 30, 2025 showed that a personalized, precision medicine approach to cognitive decline was…
TL;DR: Your bones and brain decline together in midlife—not by coincidence, but because estrogen protected both and now it’s gone. A DEXA scan in your 40s isn’t just about fracture risk; it’s an early warning system for your 70s brain.…
Discover how Dr. Manna has been helping women understand their risk, identify the factors influencing their brain health, and take meaningful action to protect their future.
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