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Overlooked for decades: Why women experience diseases differently than men

How hormones affect health is different for women of all ages.
Three generations, three hormone levels - Leipzig researchers want to understand what this means for women's health. © Colorbox
From: Wissensland
For decades, women were excluded from medical studies. Researchers at Leipzig University are now investigating how hormones shape the brain — and why this is crucial for women’s health.

Women and men often react differently to medication, stress or illness. Nevertheless, for decades the male body was considered the standard in medicine. Until the 1990s, women were excluded from many clinical studies, partly out of concern that hormonal fluctuations could "complicate" research results.

The consequences of this data gap are still noticeable today: diseases often manifest differently in women, are recognized later and are sometimes treated less effectively. Two researchers at Leipzig University are working to change this.

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How hormones shape the brain

Julia Sacher and Veronica Witte are conducting research at the Leipzig Center of Metabolism (LeiCeM) Cluster of Excellence on a question that has long received little attention: What role do hormones play for the brain? "Biological sex, but also the way we treat women and men in society, has been shown to influence how the brain and body react to stress, medication or illness," says Sacher, Professor of Cognitive Neuroendocrinology at Leipzig University Hospital and the Max Planck Institute for Human Cognitive and Brain Sciences. If these differences are ignored, important biological connections are lost.

With the help of modern MRI technology, Sacher and her team were able to show that central memory regions of the brain actually change during the menstrual cycle. The female sex hormone oestrogen appears to play a protective role for the brain and memory. Particularly during the menopause, when oestrogen levels fall, the risk of dementia and depressive disorders apparently increases. "The menopause therefore sets the course for how we age cognitively," explains Sacher. Despite this, less than one percent of neuroimaging research has so far focused on women's health.

Women's gut, diet and brain

Witte is also investigating hormonal transition phases in women's lives. Her focus is on the gut microbiome, i.e. the billions of bacteria in the human gut. These microorganisms apparently not only influence digestion, but possibly also the brain. "There are indications that certain bacteria in the gut could reduce the permeability of the blood-brain barrier via various signaling pathways," explains Witte. The blood-brain barrier is a kind of protective barrier between blood vessels and the brain. If it functions better, nerve cells could work more stably and thinking could be protected in the long term.

Witte now wants to use the so-called INFLAME study to investigate how nutrition, intestinal bacteria and hormonal changes influence each other. The study is aimed at women in the perimenopause, i.e. the hormonal transition phase before the menopause. During this time, hormones, metabolism and blood vessels undergo profound changes. Witte suspects that the protective effect of oestrogen on blood vessels and metabolism diminishes, which could promote diseases such as high blood pressure or diabetes. Female participants are still being sought for the INFLAME study.

Why gender-specific medicine is becoming increasingly important is also the topic of the UKL Health Forum 2026 on May 30 in Leipzig. Sacher and Ulrich Laufs will be discussing the question: "Do we need to think differently about medicine for women and men?"

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