2024 Inaugural CAMH womenmind™ Conference: Advancing Research on Women’s Mental Health
Author: Romina Garcia de leon, PhD Student, University of Toronto/CAMH & Laura Gravelsins, PhD, Postdoctoral Fellow, CAMH | Editors: Jena Roy, Manager, Philanthropic Gifts, Research (womenmind) CAMH; Bonnie Lee, PhD Candidate, University of British Columbia, CAMH
Published: May 10th, 2024
On April 17th and 18th 2024, CAMH womenmind ™ hosted the inaugural conference on Advancing Research on Women’s Mental Health in Toronto. Across 9 symposia, this conference delved into diverse areas of women’s health research. Women’s mental health research has been chronically underfunded and understudied, which has resulted in worse health outcomes for women, girls, and gender-diverse people. Over 450 people gathered from around the world with a shared purpose: to learn from leading experts and catalyze meaningful change in the field of women’s mental health research.
The diversity of speakers made the event dynamic, with research scientists, clinicians, people with lived and living experience experiences, and healthcare advocates sharing the stage. As Dr. Liisa Galea, the inaugural womenmind Trevling Family Chair in Women’s Mental Health and Senior Scientist at CAMH, emphasized during the closing speech: “If healthcare is our boat and our healthcare practitioners are the crew, research is the compass that shows them where to go.” It is the synergy of these forces that will reshape the landscape of healthcare for women, and ultimately lead to better health for all. This blog will highlight a couple of lessons learnt from some of the brilliant speakers at this conference.
What do we know about how hormonal cycles impact mental health?
For some time now, we have understood that hormones impact mood. As Dr. Benicio De Frey and Dr. Marija Kundakovic both stated in their talks, it is times of hormonal fluctuations that increase the risk for mood disorders (like depression, and anxiety). Premenstrual dysphoric disorder (PMDD), the severe form of premenstrual syndrome (PMS), appears to affect 5–8% of individuals who menstruate. PMDD is often difficult to diagnose as it shares similar symptoms to depression, PMS, and bipolar disorder, and this leads to incorrect or delayed treatments. Additionally, an accurate diagnosis requires consistent data for 2 months, showing that symptoms coincide in the period preceding menstruation (luteal phase). Dr. Frey’s team created the ‘McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS)’ to track symptoms across the menstrual cycle, allowing individuals suffering from symptoms of PMS or PMDD to take control of their health and bring this data directly to their healthcare providers.
Do we know how sexual orientation plays into mental health?
Structural stigma and discrimination are associated with adverse mental health outcomes. Dr. Robert Paul Juster’s talk revealed that structural stigma can directly impact an individual’s physiology. Dr. Juster’s research considered whether stress and sex hormones varied depending on sexual orientation. Following a mild stressor, lesbian, gay and bisexual (LGB) women had higher levels of testosterone, progesterone, and cortisol reactivity compared to heterosexual women — the same wasn’t seen in gay and bisexual men. Another study investigated daily morning cortisol levels of LGB versus heterosexual individuals and found that differences in cortisol levels only became apparent when the data was separated by those who had disclosed their sexuality to their friends and family, as those who had not disclosed their sexuality showed higher levels of diurnal cortisol. Understanding how stress and biomarkers of stress differ by sexual orientation and individual experiences brings us closer to achieving precision medicine.
How does menopause affect the aging brain?
Menopause involves a steep depletion of circulating sex hormones, with implications for profound changes in the brain, as several speakers discussed. For instance, Dr. Natasha Rajah talked about how her team has been contributing to the Brain Health at Midlife and Menopause Study (BHAMM). A central aim of BHAMM is to diversify the cognitive neuroscience of aging research, recognizing that much of our aging research comes from highly educated white individuals. Another is to investigate how menopause status affects memory and memory-related brain activity. Some notable findings are that lower spatial context memory and decreased activity in certain brain regions associated with encoding and retrieval were associated with postmenopausal status and advanced age. Her research suggests that menopause amplifies the effects of chronological aging. Studying female-specific experiences such as menopause can reveal differences in the aging trajectory and implications for disease risk. Moreover, research must examine specific hormonal experiences across different sexes and genders, as they can have unique contributions to health and disease outcomes
The impact on people with lived experiences and advocates driving change:
The symposium titled “Elevating Voices: Integrating Expertise and Advocacy in Collaborative Research for Greater Impact” was the heart of the conference. Megan Pilatze shared the story of her late autism diagnosis and the difficulties she faced navigating the healthcare system that didn’t understand her. Megan had sought help for her mental health on several occasions and was diagnosed and medicated but her symptoms prevailed. It was only after reading a book titled “Women and Girls With Autism Spectrum Disorder” by Sarah Hendrickx that Megan realized she had been misdiagnosed her whole life. After seeking an (expensive) Autism assessment, she received her diagnosis at the age of 31. Megan highlighted that males are predominantly diagnosed with autism (3:1 male-to-female), but most research insufficiently focuses solely on caucasian males. There is also a diagnostic sex bias where females are less likely to be diagnosed because the screening criteria cater to characteristics that do not reflect the presentation of autistic females. Furthermore, Dr. Meng-Chuan Lai presented his research that demonstrates that females display more masking behaviours than males. Together, it is apparent that more research is needed on how symptoms and manifestations of autism differ in females versus males, and excluding these differences in research can be extremely harmful.
Patricia Tomasi, co-founder and Executive Director of the Canadian Perinatal Mental Health Collaborative(CPMHC), shared that 1 in 5 individuals in the postpartum stage develop postpartum depression — affecting 80,000 families in Canada per year. Patricia suffered from an extreme form of postpartum depression and psychosis throughout both of her pregnancies (read her story here). While seeking medical help, Patricia was sent home without any support on multiple occasions and had to continuously advocate for herself to her doctor to receive a diagnosis. As a result of her lived experiences, Patricia works tirelessly to amplify the stories of women who have suffered through postpartum depression, as not all people suffering end up receiving appropriate care and support before catastrophic consequences, such as suicide. The CPMHC does an annual walk for perinatal mental health named “Flora’s Walk for Perinatal Mental Health.” The stories that Patricia and those at the CPMHC have brought to life fuel the research and help bring perinatal mental health to the forefront of healthcare concerns. Patricia proposes that Canada implement a Perinatal Mental Health Strategy that would create lasting and systemic change for birthing parents, and families.
All the speakers and inspiring conversations during the womenmind conference provided invaluable insights and underscored the stark reality that achieving health equity across sex and gender remains a long journey ahead. Advancing women’s mental health research will improve care for 51% of the world’s population, through early intervention to prevent mental illnesses and personalized treatments to ensure better outcomes. Research is vital to our success and we look forward to driving change and gathering again for the next CAMH womenmind Conference.
