Episode 122: Menopause and the Brain

What actually happens in the brain during menopause, and why do some people experience hot flashes, sleep disruption, anxiety, and other symptoms more severely than others? In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with menopause researcher and OB-GYN leader Dr. Genevieve Neal-Perry about the neuroscience of menopause and how new discoveries are changing treatment. They explore what happens in the hypothalamus as estrogen levels change, the role of KNDy neurons and neurokinin signaling in hot flashes, and how this research led to targeted nonhormonal treatments for vasomotor symptoms. Dr. Neal-Perry also discusses fezolinetant and other neurokinin receptor antagonists, including how these therapies differ from hormone therapy and why they may expand treatment options for people who cannot or choose not to use hormones. The conversation also examines findings from the Study of Women’s Health Across the Nation (SWAN), including differences in the timing, severity, and duration of menopause symptoms across populations. Dr. Neal-Perry explains why menopause may present through symptoms clinicians do not immediately recognize, including sleep problems, anxiety, heart palpitations, and joint pain, and why listening carefully to patients remains essential. From the brain biology behind hot flashes to emerging nonhormonal treatments, this episode explores what clinicians need to know about the evolving science of menopause and how it is reshaping menopause care. Read Transcript: https://mcdn.podbean.com/mf/web/mfgj27ddw3x6nec5/Transcript_medcast_episode122.pdf  CME Information: https://stanford.cloud-cme.com/medcastepisode122 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4179

What happens when prisons become responsible for caring for people with dementia, cancer, disability, and other complex health needs? In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with Pulitzer Prize-winning investigative journalist Julieta Martinelli about the growing population of older adults in U.S. prisons and the healthcare challenges that come with aging behind bars. Drawing from her reporting, Martinelli shares the stories of Frank Ross, who was released from prison at age 93 after developing cancer and dementia, and Mechie, who navigated breast cancer diagnosis and treatment while incarcerated. Their experiences reveal the often-unseen realities of healthcare in prison, from incarcerated people serving as caregivers for one another to barriers to accessing timely care, the complexities of compassionate release, and the challenges of maintaining continuity of care after decades of incarceration. The conversation also explores what clinicians can learn from these experiences, including the importance of recognizing trauma, building trust, and understanding the health history a formerly incarcerated patient may carry into the clinical encounter. Read Transcript CME Information: https://stanford.cloud-cme.com/medcastepisode121 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4115

Kids aren't little adults — and in pediatric sports medicine, that difference shapes everything. In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with Dr. Kevin G. Shea, Chambers-Okamura Endowed Professor of Pediatric Orthopedics and Division Chief of Pediatric Orthopedics and Sports Medicine at Stanford Medicine Children's Health, about caring for athletes whose bones are still growing. Dr. Shea explains why open growth plates make young athletes vulnerable to different injury patterns than adults, why ACL tears, meniscus injuries, and osteochondritis dissecans (OCD) are being seen more often and at younger ages, and how year-round, single-sport specialization may be driving overuse injuries. He also shares how multicenter research collaborations like ROCK, PRISM, and SCORE are building prediction tools that help families weigh surgery against nonoperative healing, why criteria-based return-to-sport assessment matters during the high-risk months after surgery, and what should prompt frontline clinicians to refer a young athlete to a specialist. Whether you're a pediatrician, family physician, emergency clinician, physical therapist, athletic trainer, or orthopedic specialist, this conversation offers a practical framework for protecting growing bodies and the long-term musculoskeletal and emotional health of young athletes. Read Transcript: https://mcdn.podbean.com/mf/web/afkpcckyu8xx4p8c/medcast_episode120.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode120 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4000

In this episode of Stanford Medcast, Dr. Geoffrey Tabin discusses the global burden of avoidable blindness and the systems-level barriers that continue to limit access to high-quality eye care worldwide. Drawing on decades of experience building scalable eye care programs in Nepal and Sub-Saharan Africa, Dr. Tabin explores how cost, workforce design, infrastructure, mentorship, and innovation shape the delivery of ophthalmologic care in low-resource settings. The conversation also examines lessons applicable to high-resource healthcare systems, including opportunities to rethink efficiency, sustainability, and equitable access to care. This activity is designed for clinicians and healthcare professionals interested in global health, healthcare delivery, systems innovation, and ophthalmology. Read Transcript: https://mcdn.podbean.com/mf/web/4m3dcruszi9hcvbc/medcast_episode119.pdf  CME Information: https://stanford.cloud-cme.com/medcastepisode119 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3955

AI companions are reshaping adolescence at a rapid pace, changing how teens connect, cope, and access support. In this conversation with Nina Vasan, MD MBA, Clinical Assistant Professor of Psychiatry and Behavioral Sciences at Stanford University, we explore the promise and the pitfalls of AI in youth mental health: what’s helping, what’s worrisome, and when reliance may become concerning. Dr. Vasan shares practical clinical guidance on what clinicians should watch for as AI becomes an everyday presence in society, helping families navigate the opportunities and challenges of an increasingly AI-enabled world. Read Transcript: https://mcdn.podbean.com/mf/web/seybvpaiws2kfiuy/medcast_episode118.pdf  CME Information: https://stanford.cloud-cme.com/medcastepisode118 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3900

Many physicians feel confined by traditional career path, but medicine is evolving, and so are the possibilities. Join Dr. Naomi Lawrence-Reid, pediatrician and founder of Doctoring Differently, as she shares how she reimagined her career to create greater flexibility, autonomy, and fulfillment. Through her journey across diverse roles, from telemedicine to advisory work, Dr. Lawrence-Reid offers a fresh perspective on practicing medicine in a way that aligns with your values, reduces burnout, and opens new avenues for impact and income. Read Transcript: https://mcdn.podbean.com/mf/web/jfb7b4incn2u4p2k/medcast_episode117.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode117 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3858

Autism is a spectrum with unique stories for every child. In this episode, Dr. Grace Gengoux, PhD, Clinical Professor, Director of the Autism Intervention Clinic, and Well-being Director at Stanford University, guides us through the latest science behind autism, from diagnosis to everyday care. Learn how clinicians explain autism in clear, evidence-based terms, how families can access essential services, and practical strategies to support both children and caregivers. We also explore genetics, DSM-5 updates, and how to navigate care pathways with confidence and compassion. Read Transcript: https://mcdn.podbean.com/mf/web/95yi3fcayn9zbk5v/medcast_episode116.docx CME Information: https://stanford.cloud-cme.com/medcastepisode116 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3810  

Nursing is at a pivotal moment and bold leadership is shaping what comes next. Join Dale E. Beatty, DNP, RN, Chief Nurse Executive and Senior Vice President at Stanford Health Care, for a candid conversation on the future of nursing practice and education. Drawing from his experience leading system-wide transformation, Dr. Beatty reflects on workforce challenges, the evolving role of nurse leaders, and what it truly takes to build cultures where care, innovation, and people thrive. This discussion offers a forward-looking perspective on how nursing can move beyond resilience toward redesign—reimagining education, leadership, and mentorship to meet the demands of modern healthcare. Read Transcript: https://mcdn.podbean.com/mf/web/hne2dtewsdptzyas/medcast_episode115.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode115 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3756

Artificial intelligence is reshaping how clinicians think and care for patients. In our conversation with Jonathan Chen, MD, PhD, Associate Professor of Medicine and Biomedical Data Science at Stanford University, he shares how AI has enhanced his own clinical work and the practical steps that foster trust and adoption among clinicians. The discussion goes beyond technology to explore the emotional dimensions of care, address bias, and outline the safeguards needed to use AI responsibly. We also review AI’s impact on medical education and the evolving hospital landscape for responsible, future-ready AI-enabled care. Join us for a thoughtful exploration of the promise, challenges, and path forward to integrate AI into clinical decision making. Read Transcript: https://mcdn.podbean.com/mf/web/azksrmc6hatbfdfq/medcast_episode114.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode114 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3726

In a rapidly evolving healthcare landscape, the intersection of technology and medicine is paving the way for groundbreaking advancements. Join us for a conversation with Dr. Jessica Mega, a Cardiologist at Stanford and a pioneer in precision health. Dr. Mega shares her insights on the transformative potential of precision medicine and artificial intelligence in diagnostics, as well as the challenges that lie ahead. Discover how interdisciplinary collaboration among engineers, data scientists, and clinicians is driving innovation, and learn about the vital role of precision medicine in preventive care and population health. With a focus on preparing the next generation of clinicians, Dr. Mega offers guiding principles for fostering innovation in health technology. Read Transcript: https://mcdn.podbean.com/mf/web/syejzt9pgskrrn54/medcast_episode113.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode113 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3685