“Menopause is a biological inevitability. Half the population will experience it,” says neuroscientist Nahid Zokaei, who in her startup Cerebella is creating tech to ease menopause brain fog.
“There is always going to be a need. Unfortunately, we haven’t addressed it until now”.
Zokaei, a former Oxford researcher and Chief of Science at Brain+, a Danish digital therapeutics firm, is determined to change that. Her venture is on a mission to clear the midlife mental fog by harnessing technology for women’s brain health in an area experts say has been underfunded for too long.
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Silent brain fog crisis
In a busy boardroom, a 52-year-old executive fumbles for a word she suddenly can’t recall. At home, a tech-savvy mom finds her concentration evaporating by mid-afternoon.
For decades, women’s cognitive struggles around menopause were shrugged off or euphemistically labelled ‘brain fog’. This catch-all term masks a spectrum of symptoms.
Both chalk it up to menopause brain fog, an almost taboo topic that half the population faces, yet medicine has long ignored.
For decades, women’s cognitive struggles around menopause were shrugged off or euphemistically labelled “brain fog”. This catch-all term masks a spectrum of symptoms.
Zokaei emphasizes it is also “a neurological transition state”. The brain is directly affected by fluctuating estrogen. Even classic symptoms like hot flushes stem from the brain’s thermoregulation going awry during hormonal change.
“We reduce it to a simple thing like menopause is all brain fog,” Zokaei notes, “but brain fog is many things, from memory lapses and concentration gaps to motivation loss and fatigue.”
Up to 60–80 percent of women in midlife report these cognitive difficulties. Yet until recently, the medical community paid little attention. Menopause has often been seen purely as a hormonal transition.
Neglecting women’s midlife brain health has consequences far beyond personal frustration. Cognitive symptoms can erode confidence and productivity at work and home. In the UK alone, one in ten women leaves the workforce due to severe menopause symptoms.
Fourteen million working days are lost annually – an estimated £1.8 billion GDP loss attributed largely to menopause-related cognitive issues.
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Economic toll
Globally, the economic toll of menopause in the form of health costs and lost productivity is pegged at around $810 billion per year.
If women’s brain health needs were better addressed, the gains could be enormous. One analysis estimates that closing the gender gap in brain health could add $250 billion to the world’s annual economic output. It’s a societal challenge as much as a personal one.
According to the World Economic Forum and the McKinsey Health Institute, women, on average, spend nine additional years in poor health compared with men. This hinders their participation in education, the workforce, and society at large” – a gap driven in part by neglected issues like brain health in menopause.
Little wonder that thought leaders call for greater investment in ‘women’s brain capital’ and urge innovators to develop tools and interventions tailored to women’s neurological needs.
Bridging science and Silicon
Nahid Zokaei has spent her career at the intersection of neuroscience and innovation.
“I’m a cognitive neuroscientist by trade,” she says, recounting years running a research lab on ageing and cognition at Oxford.
At Brain+, she helped digitize non-drug treatments for dementia, translating lab insights into app-based therapy. But one finding nagged at her: In virtually every study on brain ageing, women showed distinct patterns – only for researchers to often control for sex differences and ignore them.
“We always ignore it,” she admits of the old approach to research. “You just say, ‘oh, we controlled for it’. Let’s talk about the general picture”.
The general picture, unfortunately, left women’s specifics behind.
Aha moment
Zokaei’s ‘aha moment’ came as she dug into menopause literature. The data were eye-opening. Menopause isn’t just about ovaries but about the brain. As estrogen levels oscillate and plummet, women’s brains undergo measurable changes in metabolism and structure.
Brain imaging studies show healthy women in midlife have significantly lower brain energy use and white matter volume compared to men of the same age, along with more amyloid plaques associated with Alzheimer’s – changes linked to menopause as a critical period.
Two-thirds of Alzheimer’s patients are women, a discrepancy researchers like Dr. Lisa Mosconi and Dr. Roberta Brinton believe is connected to menopause and its aftermath.
“Every woman who lives long enough goes through menopause, but not all women develop Alzheimer’s,” Brinton tells Nature, suggesting midlife interventions could be a window of prevention.
Motivated by this emerging science and a sense of injustice, Zokaei founded Cerebella in early 2025. The startup’s premise is to combine precision diagnostics with personalized, drug-free therapies to support women’s brain health in peri- and postmenopause.
No current solution
It’s a bold departure from the status quo.
“No current solution addresses menopause-related cognitive impairments,” Zokaei observes, noting that too often women are left to cope on their own or given unsatisfactory advice.
In the UK, 30 percent of women over 35 reportedly see a doctor five to ten times before getting a proper menopause diagnosis, a figure even higher for women of color. Even after diagnosis, nearly half wait over a year to receive treatment.
Many are misdirected: One in three women aged 35–60 is prescribed antidepressants for menopause symptoms despite guidelines advising against such off-label use.
“Eighty percent of women report receiving inappropriate treatment post-diagnosis”, Zokaei notes. The frustration in these statistics was fuel for her venture. Cerebella set out to fill this void with a solution that women could trust and access on their terms.
Precision brain health
What makes Cerebella stand out in a sea of health apps is its blend of cutting-edge cognitive science and a deep understanding of women’s lived experience. The platform, currently in prototyping, will offer a two-pronged service: advanced brain health assessment and personalized training exercises, all delivered via a smartphone or tablet.
On the assessment side, Cerebella uses what Zokaei calls “detailed phenotyping of the cognitive landscape” for each user. In plain terms, that means it goes beyond generic ‘How’s your memory?’ questionnaires.
Instead, the app administers gamified cognitive tests, symptom tracking, and even taps into wearable device data to build a rich, individualized profile of each woman’s brain function. Memory, attention, processing speed, mood, and sleep patterns are all measured with greater nuance.
“We’re collaborating with people at the forefront of developing the coolest ways to measure memory and attention,” Zokaei explains, because new digital metrics can capture subtle changes that old paper-and-pencil tests miss.
Data-driven approach
By comparing a user’s performance to peers of similar “cognitive phenotype,” Cerebella can highlight personal strengths and weak points. Crucially, this data-driven approach allows the app to predict which cognitive domains a woman might struggle with as her menopausal transition progresses.
“Once you have large data, you can have some predictive power of what the weak point is and then personalize that intervention,” Zokaei says.
In other words, Cerebella aims to catch emerging issues early and tailor support accordingly – hitting the sweet spot of challenge where tasks are neither too easy and boring nor too complicated and frustrating.
The second prong is intervention: Cerebella delivers a structured, evidence-based cognitive training program that is entirely non-pharmaceutical. Zokaei proudly notes it is the only non-drug therapy explicitly designed for cognitive impairments in perimenopause, co-developed with a leading professor in the field.
“This is like a four-to-six-week program. We’re working on an eight-week one,” she says, describing a curriculum of mental exercises and coping strategies. The program draws on techniques proven in clinical research: mental stimulation tasks to sharpen memory and attention, cognitive behavioral strategies to manage brain fog, mindfulness and relaxation practices to reduce stress, and community features to combat apathy.
Personalized brain fitness
Essentially, Cerebella’s intervention functions like a personalized “brain fitness” coach for midlife women. And while it’s not meant to replace medical care, it can complement treatments like hormone therapy or simply provide an option for those who can’t or prefer not to take medications.
By the end of the program, women are expected to not only feel mental clarity returning in daily life, but also gain tools and habits to sustain their cognitive health long-term.
The ultimate goal is to promote “mental fitness” and “cognitive longevity” for women in midlife, potentially even reducing the risk of future neurodegenerative disorders through early preventive action.
Rooted in science
All of this is grounded in rigorous science. “Cerebella is rooted in science,” Zokaei stresses. She’s assembled advisors from Oxford, Monash, and University College London to bridge the gap between ‘blue-sky’ research and real-world solutions.
“The tools we test and use in clinics are the tools that were developed 40 years ago,” she explains, pointing out how cognitive assessment in both dementia and menopause often relies on outdated questionnaires.
“But our knowledge has shifted so much. The ways to assess cognition have improved a lot”, says Zokaei.
Cerebella’s platform is essentially a vehicle to bring those 21st-century neuroscience advances – from validated brain games to AI-driven analytics – directly into women’s hands.
The timing is apt. A Nature Reviews Psychology article this year highlighted the proliferation of behavioral interventions for menopause symptoms and called midlife “a time of psychological growth” if women get proper support.
By leveraging such approaches, Cerebella aligns with a growing consensus that non-drug, mind-body therapies can greatly help women manage menopausal challenges.
Meeting a market need
Beyond the science and altruism, there is a very real market opportunity driving Cerebella’s momentum.
“Unlike any other thing, menopause is a biological inevitability,” Zokaei quips – meaning an ever-renewing customer base is built into the human life course.
Today, women in their 40s, 50s, and 60s are more digitally connected than ever and hungry for solutions. Over 50% of women are actively seeking help for brain-related menopause symptoms, according to market research, yet most do not trust current solutions as they are perceived as non-scientific.
This trust gap is exactly what Cerebella hopes to overcome by branding itself as a science-backed, expert-developed platform. And women appear eager to engage.
“It’s so easy to find women who want to participate,” Zokaei says of the startup’s early user research. The development process – which involves co-creating with perimenopausal women – is “going faster than we predicted” thanks to the enthusiasm, she notes.
Investors taking note
Investors and industry observers are taking note, too. The femtech sector, i.e. technology for women’s health, has exploded in recent years, and brain health in particular is a ripe frontier. Cerebella positions itself as a first mover in cognitive menopause care, with few, if any, direct competitors focusing on the brain side of menopause.
Most menopause startups focus narrowly on hormones or hot flashes, or offer general wellness and coaching. None tackle the brain fog head-on with a dedicated intervention.
By targeting this “white space,” Cerebella has a chance to define a new category – one with meaningful social impact.
“Menopause is a high-need, high-growth segment,” Zokaei notes, pointing out that digital health is now mainstream for women over 30. They are top spenders on health apps. Just in the UK, there are about 13 million women in perimenopause; globally, the number is in the hundreds of millions.
If even a fraction of the market adopts solutions like Cerebella, it represents a multi-billion-dollar market. But more compelling than the return on investment are the human and economic efficiencies a product like this could unlock. Imagine fewer women leaving careers at their peak, or cutting down those repeated doctor visits for elusive answers.
Fundraising and research partnerships
Early evidence suggests that supporting women’s cognitive health could keep them working, thriving, and contributing longer. One internal analysis highlighted that “unlocking women’s brain capital” particularly in midlife might generate $250 billion in global GDP by reducing health burdens and keeping experienced women in the workforce.
Zokaei is careful not to oversell the hype. As a scientist-founder, she is focused on building credibility step by step. The company is in the process of raising seed funding and securing research partnerships.
“We’re applying for a lot of research grants,” she says, to complement investor capital.
Clinical trial on the way
A three-arm clinical trial is planned, with Cerebella’s app as one arm, to validate its effectiveness formally. By comparing women who use the app against those who don’t, and possibly those who get an alternative intervention, the team wants solid data to back their claims.
By addressing an issue so long relegated to whispers and eye-rolls, innovators like her reframe menopause from a private struggle into a public priority.
“We want to validate it properly so that in the long term, we can have Cerebella as part of the reimbursement systems in health care”, Zokaei explains. In other words, the vision is to integrate this solution into standard care pathways – perhaps even get it covered by national health services or insurers as a preventive benefit.
To that end, Cerebella is forging pilot programs with forward-thinking general practitioners and clinics in the UK, and talking to major pharmacy chains that have launched menopause support initiatives.
If these pilots show that Cerebella can reduce GP visit frequency, shorten wait times, or improve women’s reported well-being, it could strengthen the case for broad adoption.
“Once we have calculations in a real life setting with the healthcare system, then we have a stronger case to sell the product to the NHS with solid data,” Zokaei says matter-of-factly.
It’s an unusually measured approach for a startup – more moonshot than quick flip. But it fits the company’s ethos of being optimistic but grounded.
One neuron at a time
Cerebella’s journey is just beginning, but its impact could be profound. It signals a shift in how we think about women’s health and technology’s role in it.
“Brain health in perimenopause affects individuals, their families, employers, and healthcare systems,” Zokaei reminds us.
By addressing an issue so long relegated to whispers and eye-rolls, innovators like her reframe menopause from a private struggle into a public priority.
The work is as much about empowerment as it is about neurons and synapses. Each personalized cognitive exercise and each insightful data point gives a woman agency over a part of life that previously felt out of control or invisible.
Cerebella shows how digital tools can solve a deeply human problem. They can turn what half of humanity endures into a thriving opportunity for wellness, innovation, and even economic growth.
The next time that 52-year-old executive steps into the boardroom, perhaps she’ll have Cerebella in her pocket as a safety net for her brain and confidence.
Zokaei’s favourite mantra captures it well: Embrace change, empower minds.