On Unlocking Women's Brain Health - Women's Health Series with Ann-Marie de Lange

Episode Transcript

Claire Murigande

00:05

Hello and welcome back to Narratives of Purpose. You are now tuned into a new episode showcasing unique stories of global change makers who are contributing to make a difference in society.

For those of you who are listening to Narratives of Purpose for the first time, my name is Claire Murigande. I am your host on this podcast which is all about amplifying social impact. If you want to be inspired to take action, then look no further. You are in the right place. Get comfortable and listen to my conversations.

Ann-Marie de Lange

00:35

When I got into this research field is actually when I realized how little we know about women's health and I was shocked.

Claire Murigande

00:46

Today's episode is the final episode of our Women's Health series brought to you throughout this year. And my guest for this last episode is Anne Marie Delange. Anne Marie is a scientist. She leads the FemiLab research group based at the Lausanne University Hospital. FemiLab investigates risk and protective factors that influence women's brain health by analyzing clinical data, genetic data, and neuroimaging data in large scale population cohorts.

Remember to rate and review our show wherever you listen to your podcasts. We are really grateful for everyone who has taken the time to share their thoughts. Thank you for your feedback and we also want to hear from you. So please tell us what you think of these conversations.

All right, now let's dive into the discussion with Anne Marie. So, Anne Marie, welcome to Narratives of Purpose. How are you doing today?

Ann-Marie de Lange

01:46

Thank you so much for having me. It's great to see you. All is well. It's a sunny day in Lausanne.

Claire Murigande

01:52

Would you mind sharing a few words of your background and especially what led you to the field of brain research and neuroimaging?

Ann-Marie de Lange

02:04

Yes, I can do that. So I'll try to make it short, but I trained actually as a clinical psychologist.

So when I was doing my practice years, I became very interested in the brain and I moved on from that to doing then a PhD in neuroimaging where I focused mostly on brain aging. And then after my PhD, there was a period where I didn't have a job, which can often happen.

And that gave me a bit of space and time to really think about my next steps and what I was interested in.

And during this time I talked a lot to my mom and we kind of concluded that working with women's health and working with women, it could be something very meaningful to do.

So actually what I did was that I set up a consultancy and I planned to sort of go back a bit to counseling and help women navigate health and, you know, workplace issues.

But then in the middle of all of this, a big research project turned up in Oslo and there was someone that I knew who was running this and it involved scanning women's brains before and after pregnancy. I found it so fascinating and this is something we know very little about.

So I got in touch with him and all of a sudden I was back in academia, started working with, with the leader of this project and eventually then I decided to apply for funding to run more women's health related research projects. And that is how I ended up in Lausanne with my research group, FemiLab.

Claire Murigande

03:44

Great, thank you for the introduction. And you know, I was just before we, we started recording, I went back again to listen to your TED Talk.

So I'll make sure to all our listeners that I'll put the link in the episode description. There's an amazing talk that Ann Marie gave last year, December 2023, TEDx, Zurich.

And I love the way it starts because you actually say that if women had health issues, whatever that health issue was in the 19th century, they were basically diagnosed with the same thing. And it speaks a volume to, as you were saying, the knowledge that we have a lack of knowledge, but also somehow that we didn't even look into it.

So before we speak about FemiLab and exactly what you do in terms of women's brain research, can you also give our listeners a bit of a context and a sense of representation of women's health within research?

Ann-Marie de Lange

04:39

Yes, absolutely.

And I think that also forms part of my background because when I got into this research field is actually when I realized how little we know about women's health. And I was shocked. I really didn't know at all. And we're just talking a few years back now. Right. So it was not really communicated, I think, either how little that we know. So I suppose the historical background is still with us. Right.

So there was a long period where women were always diagnosed with hysteria for any type of health concern. And then I guess eventually that did improve. But we had other issues as well, such as women being excluded from medical trials.

And that has this background in concerns really about, you know, reproductive problems. So some listeners might have heard of this thalidomide tragedy.

I don't know if you're familiar with it yourself, but it was in the 50s and the 60s, there was this drug that came onto the market. Many women took this during pregnancy and it was supposed to help from nausea, I think.

And unfortunately the, you know, the consequences were terrible. So a lot of babies were born with very severe birth defects. And this terrified everyone, of course.

So, you know, with good intentions, women started to get excluded from different types of drug trials.

But another consequence of that, again, of course, is that are we not supposed to have any clinical research on women then in case something bad can happen? So then we end up with very little knowledge about women's bodies and women's health. And.

Yeah, so I think these things are starting to change, but we still very much feel the consequences as individuals. Right.

I don't know about you, but I know a lot of women who have stories where they have gone to some healthcare provider and they have issues and they do not get so sufficient health. Yes.

Claire Murigande

06:50

That's a common story, I have to say. And I don't think there's one woman that I know who doesn't have a specific story about that.

And to make it even more complex is if you add in all the intersectionalities as we talk about for women. Right. Like my roots are in East Africa.

So when I'm here going to a doctor for many drugs that have been studied, maybe they don't know exactly how it will impact my physiology. Right. Because there's no data.

You know, I can’t blame them. There's just no data. And as you were saying before, it came from a good intention to exclude women because of this consequence that we see.

Unfortunately, it was not a solution because it kind of extended that issue with time.

Instead of, you know, a rational decision would be okay, if there's less women, then maybe the drugs that are developed are not for women, so only men should take them. But then the thing is, everybody takes these drugs.

Ann-Marie de Lange

07:46

Exactly.

And I think you make a very good point with the intersectionality here, because as we, you and I chatted about before, you know, we have a lot of things in common as two women, but we also have life contexts that will differ and it matters like it really does. And this is also something that has not been out in the light very much at all. Right. Not in research and not really in the everyday conversations that we have.

Claire Murigande

08:15

Exactly.

But the good thing is now we're talking about it, not only now here on the podcast, but it's also a topic that's coming up more and more today. And again, women are empowered.

I don't know if people don't like using that word, but at least, you know, we're using our voices out there, whether it's our wellness and our health and well being in the workspace, you know, whether it's aging, you name it. So obviously there's lots and lots of challenge.

And one of them, as you were saying before, in terms of research, I also have a scientific background is the, the availability of the data, which leads me now to coming back to FemiLab, which is your lab. So tell me how it all started. But specifically, like, what is your aim with this lab?

Ann-Marie de Lange

08:55

I think you're getting straight to the challenges, right, with the lack of data, because that really is a big problem and maybe especially for us, because we are trying to look at large population based samples. Thousands of people have been scanned and measured around the world. Right. But very often we see that the right questions have not been asked. Right.

And the right measurements have not been taken.

So I think some samples now have, for example, the UK Biobank there, we actually have some proxy measures of sex hormone exposure, for example, number of childbirths, age of menopause, all of these factors that we are interested in.

Because what we really want to know is like, how these transitional phases in a woman's life might impact brain health in midlife and aging, for example. But we absolutely need data to be able to even analyze that. Right?

So that is an issue.

We have come further, I would say, and there are now research projects around the world where people are collecting data with women's health specifically in mind. And this is extremely important. But the problem is it takes time, right?

So you're collecting data on, you know, brain scans and body measures and hopefully also over time to be able to track people's health. So we do still have a long way to go, but I think we are moving in the right direction for sure.

Claire Murigande

10:28

You mentioned that what brought you back to academia was this project of scanning women's brains before and after pregnancy. Correct.

So how does that relate to what you're doing now? Or perhaps the other way of asking the question is how has that evolved since you started that project and now you're developing FemiLab?

Ann-Marie de Lange

10:48

So I think the pregnancy research is an important starting point because what that has shown us over the last years is that the brain is very plastic during that period. It changes a lot. And this is new knowledge, Right. And very exciting as well.

And even though we still don't quite know what these brain changes during pregnancy mean, in practice, I think we have a chance now to figure out more and also understand, for example, why women are at risk for postpartum depression and these types of things. So it's a very important angle, for sure, but it also shows us that the female brain is very intricate but very interesting.

And this isn't the only transitional period in life. Right.

So menopause is another period that has been very severely understudied and something that we are very interested in when it comes to sort of brain aging and dementia risk, for example.

So this is now becoming a pretty big field within the women's health sphere, at least, and we're trying to figure out, you know, what are the risk factors, what is the happens during the menopause that might actually lead to adverse effects on the brain later on. Because a lot of women go through menopause without severe health problems. Right.

But some have very deliberating symptoms and also struggle cognitively with memory loss, etc. Another risk is connected to cardiometabolic health. So blood pressure can go up, you can gain more fat around your tummy area.

You know, a lot of things that doesn't happen to everyone, but for some, this transition really is problematic. So we want to know, how can it be treated? Who is it that end up in a situation where things are very difficult during that time, and why?

And also, what are the long term effects of this change on the body when it comes to the brain?

Claire Murigande

12:59

It feels like obviously it's still in the beginning, in the phase we don't have all the answers. It's really observation.

Right. You see all these changes in the whole lifetime of a person and you're obviously also looking at population data, as you were saying.

I guess what I want to ask is, is with who do you collaborate or how do you work to make sure that you can really advance in answering those questions?

Ann-Marie de Lange

13:24

Yes, excellent question.

I think again, you make a very good point, because when you're looking at broad scale associations, population level, those types of analysis are not really designed to help guide clinical decisions for one person. Right.

So there is a gap here, and this gap is very difficult to address. So I think one of the things that we've been quite interested in is to establish conversations actually with the real world.

So, yeah, you mentioned the TED talk and that was a great event because afterwards I talked to lots of people who work in femtech. Right. So then you see, all right, what are you doing? And okay, you're actually developing practical tools for women.

How can we link that to the research that we're doing?

How can we try to come together and sort of go all the way from population level associations to understanding how different factors might impact different people in their actual lives? But I must say this is a big challenge.

And I think the only way to address this is to work together and not just with researchers, but beyond Academia as well. I think it's extremely important.

Claire Murigande

14:43

I don't know how much you're at liberty to talk about your projects, but are there, like, specific partnerships that you can mention in terms of what you're doing at the moment?

Ann-Marie de Lange

14:52

We're kind of operating a bit at the intersection of different institutions in Europe.

So we are based at in Lausanne, but we're working very closely with the University of Oslo, which is, you know, I'm from Norway, so I have very good relationships there. And we're also working closely with UCL and University of Oxford in the uk, which is where I worked before I came to Lausanne.

And it has been really successful, I think, to work like this. And of course, it's a privilege that we now have in this. What should we call it, Digital age. Right.

That you can be connected to people in other countries in that way. I really love that. So it has kind of enabled a lot of interdisciplinary work.

And I would say we're interested in driving the research forward more than sort of building something local that is competitive. Right.

So we care about the collaboration in terms of, like, industry collaborations. We haven't really solidified anything there yet. We're talking a lot of people and trying to sort of understand how best to work together.

But importantly, we do work a lot with clinicians. So we have sort of a. You know, we have people who are in the clinics working with patients and.

Yeah, also women, for example, the Memory Clinic here in Lausanne. And that has been immensely important as well because they help us a lot in terms of understanding which questions to ask and how to analyze data.

Claire Murigande

16:29

And you previously mentioned startups or femtech. Are you also in collaboration with smaller companies?

Ann-Marie de Lange

16:36

We're not really. Not at the moment, but I am starting to get a pretty good overview of what people are up to.

And I think there is a lot of activity in Switzerland, also in the uk, but people are doing so many interesting things. It's really, really great to see. And I think in future, currently we're applying for more money, for more projects.

And there, I think one of the key aspects will be to try to get some collaborations beyond academia to really try to sort of bridge this gap between us researchers here, other people working with us, and the actual people who we are trying to, you know, help.

Claire Murigande

17:18

And to that point, you know, obviously the lab you're leading didn't exist before you created it. So can you tell me about some challenges or how was that journey? How has it been so far?

Because, you know, this is something I ask people on the podcast, because it needs to be also relatable to see that, you know, if someone is listening and they have an idea to start something. I like to ask my guests, you know, how was that journey? So that everyone can learn from that and not repeat some mistakes.

Ann-Marie de Lange

17:44

I think one of the key things that happens when you try to create something yourself is that you, at some point, you realize that you're actually the person in charge, and you are the person that people will come to, and you actually have to make all the decisions. In the end, of course, you work together with others, and you can do it in a way where you don't feel alone.

But I think that was a bit of a transition for me, that, you know, I was always like the. I had the last word, you know what I mean? And that's quite something.

So you have to really trust yourself and you have to believe that you can do this. And I think the way to stay motivated for a challenge like that is to work with something that you really care about. Right.

So for me, women's health has had that role and has made it possible for me. But it has been challenging for sure, because, yeah, we also started this lab in the middle of the pandemic, which was.

I definitely would not recommend. No, it was really strange because we couldn't really go to work. I was trying to hire someone who I couldn't meet.

You know, we saw all the new colleagues in face masks for the first six months, maybe even. It was a long time before we could feel that, okay, this is normal, we're actually in a workplace, we can see the people around us.

But it definitely delayed networking, which is something that is extremely important in a period like this, moving to a different country and also that was a bit tough, but we have landed on our feet and it's been a really good experience in the end, for sure.

Claire Murigande

19:26

And so where do you see FemiLab in the next, say, five years, for example?

Ann-Marie de Lange

19:31

Yeah, that's a very open question, I think. So currently, we're kind of sort of a bit in transition here as well, because, well, I have a PhD student who is defending her thesis next week.

But then I think I really hope that the lab will continue to exist and hopefully also grow, but possibly somewhere else. I'm not entirely sure yet. It depends a bit on the family situation and everything.

But either way, I really think that I will take a lot of positives with me from Switzerland in terms of collaboration, and I think I've established a lot of really good relations here. People have Been very positive. It's easy to talk to people here. It's fairly small country, so, you know, and it's possible to network here. So it's.

That's been really good. So I'm hoping that, yeah, maybe more industrial collaborations will come in the future. More research, for sure.

And yeah, also more like closer connections to the clinic and also to the people.

Claire Murigande

20:43

And now on a more, I would.

Say, macro level, when we look at women's health and a state of women's health, obviously your expertise is within research, but if you look at the whole ecosystem, so to speak, what is your outlook? I'd like to see what's your take on where you see things moving forward very quickly?

Where do you see things rapidly changing and benefiting women and society as a whole at the end? And also on another hand, you know, where do you see that there's lots and lots of challenge and there's still work to be done.

Ann-Marie de Lange

21:18

I think the more low hanging fruit is actually to get women engaged because I think if you take some initiative, it's so easy to get others on board. It really is. Women are really ready, right.

To fight for the right just to be, you know, treated well and for people to actually gain knowledge about our health. It's not that much to ask for. Not really. Right.

But I think, yeah. I have this podcast with a friend in Norway. She's not in research.

It's been a really interesting experience for me because I start to sort of see the world through her eyes. And I think this whole idea about community is very important. This is something I get from her a lot, that you're not alone, right.

You're not alone in this. And if we can come together, we're actually very strong as well.

However, we cannot change everything from, you know, when it comes to like these really problematic systemic issues, if there isn't any information about women's health in a clinical education, that's a massive problem. So this is political level. We need to start a political party maybe.

Claire Murigande

22:32

Oh, I like this idea.

Ann-Marie de Lange

22:33

Yeah, yeah. Because I think you really have to try to push for changes in the system. Right. So you and I can talk and we can talk to our friends and our colleagues. And that helps too because we spread information. Right.

So that's also very important that we can start not to feel ashamed and share experiences. And that is, I think, something that does help for sure. But when it comes to the system, everything is so slow. Right.

So people will say, sure, we can put this into the education, but we don't Know enough. So you have to do more research. But we do actually know quite a lot at this stage.

We know enough to teach clinicians about women's health, I would say. Right. Even if it isn't, you know, a fully mapped out knowledge map of the female body, we still know enough, I think. So I'm really hopeful, though.

I'm optimistic because I get the sense that women are ready to try to push for change and that more and more people are talking about these things. Is that your impression as well?

Claire Murigande

23:35

Yeah, absolutely. And this year I've been focused specifically on women's health and intentionally speaking to women who are really moving the needle in this space.

And that is something that comes across very quickly.

As you were saying before, collective getting together, not feeling isolated, because that's the main challenge, where someone cannot speak up or even, you know, having that interaction with your healthcare provider. You think they know because they studied. And in fact, you know your body better than them, right?

Ann-Marie de Lange

24:10

Yeah, exactly. Yeah.

Claire Murigande

24:12

Whether it's a woman or a man, by the way, you know, and only even speaking up and advocating for yourself, self advocacy and also finding that community. And I mean, this is something I also noticed through the conversation that I had. Everything is very much, much grassroots. It's not to be neglected.

Right. It will make a difference for sure.

And we do have knowledge that's enough to already teach people, you know, medical school, I think, in Lausanne and now also in Zurich. They have a general medicine track.

So it is starting even though we don't have everything, but we do have enough to already say, listen, there are differences here, so pay attention to xyz. Right, exactly. But then to your point as well, I guess the main challenge is the systemic change.

How do you make the change at larger level, where decisions are being taken, where policies are made? Because that is also what will influence a lot of the work that's done on the ground.

Ann-Marie de Lange

25:08

Yeah. I'd like to give you an example of. Because grassroots, sometimes I think it feels a bit hopeless. Right.

Why am I the one to sit and try to initiate all of this? It should come from up there. But it does work, right? It does work. It requires energy, but it does work.

I have a sister who has gone through menopause and had a terrible time. She's much better now, and she has initiated in her work a women's health group of some kind where they have, you know, organized events.

And it focused very much initially on sharing experiences. And this is just blown up.

I mean, she's now hosting events with like hundreds and hundreds of people connecting from offices all over the world, and everybody's interested in hearing about this. And then what happens is that, of course, you get noticed by people who are higher up in the system, and they are saying, what is all this about?

Clearly, you need something. Let's talk. Right. So I really think it's worthwhile, even if it feels very small, whatever it is that people have in mind.

But if you have something you really want to fight for, I would encourage you to do so, for sure.

And another thing I also just want to mention is that with this podcast that I have in Norway with my friend, we've been talking about, for example, miscarriages and, yeah. The menopause problems after pregnancies.

And a lot of men have contacted us and been extremely positive and listened to it, and they're saying, you know, this is really important. You should continue to do so.

So that's also something to keep in mind that I think we can get men on board as well, because obviously these things are relevant for them, too. Right.

Claire Murigande

26:53

That's an absolutely great example, and I love it, because that's the whole point of having these conversations. Obviously, I'm talking to women, but this is a concern for everyone. And I like to say that knowledge is also power.

As you were saying, even if it's grassroots, it's not to be underestimated. The more you know, the more you can challenge misconceptions, common assumptions, and really wonder, why are things made like this?

Why is it designed like this? It doesn't work for my mother, my sister, my neighbor or whoever. My daughter. Right. And that's. As a parent can be also a man.

So I think the more we talk about it, as you were saying, grassroots, not underestimated. We can also make strides, and hopefully at some point that, you know, the whole system can also transform and evolve.

Ann-Marie de Lange

27:38

And I think the grassroots initiatives can also then communicate with the researchers. Right. If you have people like me who are in this field, and we are very keen to share what we know. Right.

So I think it can. Can work as a really good conversational starter if people come together in communities. Yeah.

Claire Murigande

27:58

And that's great you mentioned that. Because before we close, I wanted to ask you, is there any specific call to action for our listeners?

How can they support you or follow you, or what would you like them to take out of this discussion?

Ann-Marie de Lange

28:10

Feel free to get in touch with me if you have any ideas for, you know, events that we can organize or if there are specific things that you would like to discuss. Ideas anything, really. Right.

So I think the community aspect is important. The intersectionality point that you mentioned as well, something that we're very interested in talking more about.

And generally I just think that, you know, anything that we can do to share knowledge and experiences could be extremely helpful.

Claire Murigande

28:43

Excellent.

Thank you so much.

It's been great chatting with you and I'll make sure that we have all the links for our listeners, you know, your contacts and also the website of FemiLab. It's been a pleasure and I really am really, really looking forward and curious to see how FemiLab is going to move forward in advance.

So looking forward to staying in touch with you.

Ann-Marie de Lange

29:04

Me too. Thank you so much for having me, Claire. It was great.

Claire Murigande

29:11

Thank you so much for tuning in today. I appreciate you taking the time. That was episode 76, a conversation with Anne Marie Delange on moving Women's Brain Health Research forward.

Find out more about FemiLab's areas of research on their website at femi-lab.com I also encourage you to watch and listen to Anne Marie's TEDx talk on YouTube. As always, you'll find all the links in the show notes. If you enjoyed this episode, please share it in your network.

And if you are curious for more content about women's health from fascinating conversations on our podcast, be sure to listen to our special series released earlier this year in March in episode episodes number 66 to number 70. You can also listen to episode 38 talking about women's heart health, plus episode 42 focusing on midlife health.

That's a wrap on our series showcasing female innovators moving the needle in the women's health space. I'll talk to you again soon. Until then, take care of yourselves. Stay well and stay inspired.

This podcast was produced by Tom at Rustic Studios.