Women's brain health, at the turning point.
Why are women's brains vulnerable at midlife, and what can we actually do about it?
Professor of Medicine (Neurology), University of Toronto
Jay & Sari Sonshine Chair in Stroke Prevention & Cerebrovascular Brain Health
Founder, HER PRISM™
"Midlife is the window where vulnerability becomes wisdom."
— Aleksandra Pikula, MDEverything I do — one centre.
Six kinds of work, one question underneath all of them: women's brain health.
Selected research.
Midlife is the decisive, modifiable window for women's brain health: the years where vascular risk, the menopause transition and lifestyle converge to shape lifelong stroke and dementia risk.
This convergence is my clinical passion, and the through-line of my research, teaching, and care.
Click a title to read the paper ↗
- Stroke · 2026Midlife as the critical window for women's stroke and dementia prevention.
- Menopause · 2026When biology meets burnout: retaining midcareer women in academic medicine.
- Front Glob Women's Health · 2024Understanding gender inequity in brain health outcomes: missed stroke and intersectionality.
- Mayo Clin Proc IQO · 2024Promise of lifestyle medicine for heart disease, diabetes, and cerebrovascular disease.
- Can J Neurol Sci · 2023Women's neurology: why we need a subspecialty for half the population.
- Stroke · 2017Serum insulin-like growth factor 1 and the risk of ischemic stroke: the Framingham Study.
- JAMA Neurol · 2014Serum BDNF and the risk for dementia: the Framingham Heart Study.
- Stroke · 2013Serum BDNF & VEGF and risk of stroke and vascular brain injury: the Framingham Study.
Up to 80% of strokes and 45% of dementia are preventable.
The midlife years are our best chance to change that trajectory, for women most of all.
Collaborators & partners.
Working across institutions on women's brain health, stroke and dementia prevention.
Speaking.
Keynotes and workshops on women's brain health, the midlife transition, and physician burnout.
Upcoming
- 25Sep Women in Medicine SummitWhen biology meets burnout: retaining midcareer women in academic medicine
- 05Oct World Stroke OrganizationWebinar · Burnout, Transitions, and Mentorship Across Career Stages
- 21Oct The Midlife Brain SymposiumKeynote · Institute FLE · Stress, Burnout, and the Midlife Brain
- 10Dec European Lifestyle Medicine OrganizationWomen’s Health in Lifestyle Medicine Initiative · The brain health of women in medicine during midlife transitions
- 28Jan2027 PAVING the Path to Wellness ProgramThe Women’s Midlife Brain: A Lifestyle Medicine Prevention Window
Click any title to open its outline ↓
From Depletion to Bio-Harmony: Brain Health & Burnout in Women in Medicine›
Keynote · women in medicine · physician wellbeing- The convergence of four perspectives on one question — as scientist, clinician, woman in medicine, and physician-coach
- What happens to women's brain health when chronic stress in medicine meets the menopause transition
- How midlife depletion reshapes both personal and professional life and outcomes
- Bio-Harmony as the ultimate way forward — developed through self-healing and with others
- The HER PRISM framework — a structured way back from depletion
The Convergence Window — Burnout, Perimenopause & the Midlife Brain in Women Physicians›
Women in medicine · physician wellbeing- Why burnout, perimenopause, and cerebrovascular risk converge in midlife
- The biology beneath "resilience" — HPA axis, sleep architecture, estrogen withdrawal
- What the evidence shows about stroke and dementia risk in this window
- Individualized levers — sequencing, not a checklist
The Midlife Brain — Every Woman's Guide to Stroke & Dementia Prevention›
General public · women's-health & longevity audiences- Midlife as the critical, modifiable window for women's brain health
- The vascular roots of cognitive aging — the brain as a vascular organ
- The lifestyle pillars and how they work together
- What every woman can start doing now
Why Women's Brain Health Has Been Understudied — and What the Evidence Now Shows›
Scientific & clinical conferences- The historical research gap in women's neurology
- Sex differences in stroke, dementia, and the menopause transition
- The new evidence reshaping prevention
- Where the field must go next
The Brain at Work — Cognitive Capital & Retaining Midlife Talent›
Corporate & organizational leadership- Cognitive capital as an organizational asset
- Why midlife women are a high-value, at-risk segment of the workforce
- Organization-led vs individual-led wellbeing — the 80/20
- Practical workplace levers for brain health
Bio-Harmony — A Framework for Sustainable Leadership in Medicine›
Executives, academic chairs & healthcare leaders- The Bio-Harmony framework — biology, values, systems, integration
- Leading without depleting the nervous system
- Building a sustainable practice and culture
- From individual recovery to system change
From Vulnerability to Wisdom — A Vascular Neurologist's Sabbatical›
Keynote · fireside · TED-style- The personal story behind the science
- What stepping back revealed about burnout and recovery
- Translating lived experience into a framework
- The window where vulnerability becomes wisdom
Currently booking for 2027.
Get in touch.
Speaking, media, and research collaboration. For coaching, visit herprism.co.