New UCLA research on menopause and cognition — see what Dr. Voskuhl's team found.
Founder · Physician-Scientist · Neurologist
Changing how the world understands the female brain.
Rhonda Voskuhl, MD, is an award-winning UCLA neurologist translating nearly three decades of NIH-funded research into brain-first menopause care.
Founder · Physician-Scientist · Neurologist
Changing how the world understands the female brain.
Rhonda Voskuhl, MD, is an award-winning UCLA neurologist translating nearly three decades of NIH-funded research into brain-first menopause care.
30 yrs
NIH-Funded Research
200+
Peer-reviewed publications
15
U.S. & European Patents
UCLA
Neuroscientist & Physician
30 yrs
NIH-Funded Research
200+
Peer-Reviewed Publications
15
U.S. & European Patents
UCLA
Neuroscientist & Physician
A Pioneer in Women's Brain Health
Dr. Rhonda Voskuhl is an award-winning neurologist and professor at UCLA who is doing cutting-edge work on improving brain function during perimenopause and menopause. A rare combination in academic medicine, Dr. Voskuhl is a physician-scientist who has run a continuously NIH-funded research program for nearly 30 years and still sees patients every week in her own clinic. This combination of bench and bedside, held by the same person, is what has led to her prolific success in cognitive research and clinical care.
Her research has led to breakthrough findings about how a specific type of estrogen (estriol), a pregnancy hormone that selectively protects the brain, can improve cognitive function in women with MS. This led Dr. Rhonda to a powerful hypothesis: since 60 - 70% of women experience brain fog during menopause (rarely treated as a brain issue at all), estriol could help them also. She decided to address this major unmet need by developing a patented estrogen treatment for perimenopausal and menopausal women. She founded CleopatraRX to offer the patented therapy not just to patients in her UCLA office, but to women across the country. It is the only hormone therapy designed specifically to support cognitive function.
Dr. Rhonda Voskuhl is an award-winning neurologist and professor at UCLA who is doing cutting-edge work on improving brain function during perimenopause and menopause. A rare combination in academic medicine, Dr. Voskuhl is a physician-scientist who has run a continuously NIH-funded research program for nearly 30 years and still sees patients every week in her own clinic. This combination of bench and bedside, held by the same person, is what has led to her prolific success in cognitive research and clinical care.
Her research has led to breakthrough findings about how a specific type of estrogen (estriol), a pregnancy hormone that selectively protects the brain, can improve cognitive function in women with MS. This led Dr. Rhonda to a powerful hypothesis: since 60 - 70% of women experience brain fog during menopause (rarely treated as a brain issue at all), estriol could help them also. She decided to address this major unmet need by developing a patented estrogen treatment for perimenopausal and menopausal women. She founded CleopatraRX to offer the patented therapy not just to patients in her UCLA office, but to women across the country. It is the only hormone therapy designed specifically to support cognitive function.
Brain fog is more than a symptom. Your brain is part of who you are.
A loss of mental sharpness can affect confidence, performance, and a woman’s sense of self. Dr. Voskuhl’s work reframes menopause as a brain event and treats cognitive health as something worthy of focused research, informed choices, and proactive care.
"53 is the average age of female Fortune 500 executives. Women can’t get to menopause and cap out."
DR. RHONDA VOSKUHL
How can we better protect the female brain?
Bench → Bedside
Research designed to move from mechanism to meaningful care.
From clinical trials in multiple sclerosis to the molecular pathways of midlife memory, each chapter has moved the same question forward.
2002
Annals of Neurology
Dr. Voskuhl's group conducted the first-ever human trial of a pregnancy-dose hormone (estriol) in a putative autoimmune disease, showing reduced brain lesion activity and improved cognitive testing scores in women with MS.
Read the Paper ↗2016
Lancet Neurology
A 16-site, NIH-funded, randomized placebo-controlled phase 2 trial (n=164) confirmed estriol reduced relapse rates and was well tolerated over 24 months, with post-hoc imaging showing preserved cortical grey matter and improved cognitive scores. This is the first controlled evidence that estriol protects the brain in a clinical population.
Read the Paper ↗2023
Nature Communications
Voskuhl's lab pinpointed the mechanism behind menopausal brain fog: loss of ovarian hormones at midlife (not young age) causes hippocampal memory impairment in female mice, and this is driven specifically by loss of estrogen receptor beta (ERβ) in astrocytes, not neurons. Treating midlife mice with an ERβ-targeted ligand reversed the damage, and the same metabolic gene disruption showed up in the hippocampus of postmenopausal women. This was direct mechanistic support for why an ERβ-selective hormone like estriol should help.
Read the Paper ↗2025
Science Translational Medicine
In her most recent work, Voskuhl's lab uncovered part of why women are more susceptible to neuroinflammation than men. This is a difference long seen in conditions like multiple sclerosis, where women are affected roughly three times as often. Her lab found that Kdm6a, an X-chromosome linked gene, drives inflammation in the brain's immune cells, and that removing it protects female mice while barely affecting males. The same female-specific gene activity showed up in brain immune cells from people with MS. Metformin, an already-approved diabetes drug that acts on this same pathway, reduced inflammation only in females, pointing to a sex-specific treatment path and future drug development.
Read the Paper ↗2026
New Research
A case series of real-world experience from UCLA and CleopatraRX patients on estriol treatment (PearlPAK®) in perimenopausal and menopausal women, with publication expected in the coming weeks.
Coming Soon01
Media & Press
Featured in The New York Times (2025), Oprah's Menopause Special (2025), ABC7 (2025), and NBC's Today Show (2024). She recently sat down for an interview on the The Radically Well podcast.
02
Awards
Recipient of the Dystel Prize (2024) in MS by the American Academy of Neurology. Recipient of the Berlin Institute of Health (2018) Excellence Award for Sex and Gender Aspects of Health and Disease. Inaugural recipient of the Rachel Horne Prize (2023) for Women's Research in Multiple Sclerosis.
03
Academic Leadership
Director, UCLA Multiple Sclerosis Program; faculty neurologist, UCLA Comprehensive Menopause Program; faculty, UCLA Brain Research Institute.
04
Research & Funding
Nearly 30 years of continuous NIH funding for research on sex differences in neuroinflammation and neurodegeneration, with 200+ peer-reviewed publications and 15 U.S. and European patents on estriol-based cognitive treatment.
05
Peer Recognition
Profiled in Lancet Neurology (2024) — the #1-ranked neurology journal worldwide — and in Biology of Sex Differences (2026), which called her "a pioneer in the exploration of sex differences in the immune response."
International Recognition
Recognized by the world's most prestigous institutions.
The conversation women's brain health deserves.
Estrogen normally protects the hippocampus — the part of your brain responsible for memory and how quickly you process information. Dr. Voskuhl's research has shown that when estrogen declines at menopause, that protection goes with it, which is what shows up as brain fog: slower thinking, trouble finding words, that "on rev but going nowhere" feeling.
Dr. Voskuhl's PearlPAK® uses a different estrogen than standard hormone therapy. Most HRT relies on estradiol. We use estriol — a weaker estrogen that binds differently. In the brain, estriol activates the receptors that protect memory and cognitive function. But in breast tissue, it binds far more weakly than estradiol does, which is part of why estriol has been used safely across Europe and Asia for over 40 years.
Timing matters, too. In neurology, we know cognitive treatment works best when it starts early — before decline sets in, not after. Women are estrogen deficient for 1/3 of their life. That's why we treat at the onset of perimenopause as well as post-menopause, with the goal of protecting the brain before atrophy begins, not managing decline after it's already underway.
Why is menopause a brain event—not only a hormonal or reproductive one?
Loss of estrogen during midlife is bad for brain, bone, heart, metabolism, skin, and other systems beyond gynecology. Women will be without estrogen for a third of their life. My preclinical research showed that loss of estrogen receptor beta signaling in brain at midlife caused memory impairment and localized brain pathology. This gives scientists a biological mechanism to investigate treatments to prevent cognitive symptoms in the 60-70% of menopausal women who report them.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
How does estriol’s receptor activity differ from other forms of estrogen?
Estriol and estradiol are different types of estrogen. They bind differently to estrogen receptors and have different functions. Estriol has preferential activity on estrogen receptor beta. My work showed how the estrogen receptor beta pathway supports brain cell health and reduces brain inflammation. This is one example of why estrogens should not be treated as interchangeable, they are different compounds, with different effects on brain, breast, and other tissues.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
When does the critical window for protecting cognitive health begin?
My research focuses on what changes when ovarian hormones are lost at midlife, both acutely in the short term during hot flashes in the initial years, as well as chronically in the long term after hot flashes dissipate. Treatment targeting cognitive health needs to begin early from perimenopause and extend through menopause to prevent initial decline, then to maintain cognitive health.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
Why do women and their doctors still have so few evidence-backed choices?
Menopause research and care have historically centered on reproductive symptoms and hot flashes, while cognition has received less attention as a primary outcome. My vision calls for comprehensive brain-health research, so women and their clinicians can make decisions from scientific evidence and mechanism. They deserve more than an all-or-nothing limited option of standard MHT (yes/no), focused on hot flashes and genitourinary symptoms. Women’s brains as they age should also be prioritized.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
What might menopause reveal about cognitive risk later in life?
Menopause offers researchers a defined biological transition for studying how hormone loss, metabolism, inflammation, and memory interact. Those pathways may help illuminate later-life cognitive risk, including questions around Alzheimer’s disease, but they remain an active area of research rather than an individual prediction.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
The conversation women's brain health deserves.
Estrogen normally protects the hippocampus — the part of your brain responsible for memory and how quickly you process information. Dr. Voskuhl's research has shown that when estrogen declines at menopause, that protection goes with it, which is what shows up as brain fog: slower thinking, trouble finding words, that "on rev but going nowhere" feeling.
Dr. Voskuhl's PearlPAK® uses a different estrogen than standard hormone therapy. Most HRT relies on estradiol. We use estriol — a weaker estrogen that binds differently. In the brain, estriol still activates the receptors that protect memory and cognitive function. But in breast tissue, it binds far more weakly than estradiol does, which is part of why estriol has been used safely across Europe and Asia for over 40 years.
Timing matters, too. In neurology, we know cognitive treatment works best when it starts early — before decline sets in, not after. Women are estrogen deficient for 1/3 of their life. That's why we treat at the onset of perimenopause as well as post-menopause, with the goal of protecting the brain before atrophy begins, not managing decline after it's already underway.
Why is menopause a brain event—not only a hormonal or reproductive one?
Estriol is a pregnancy hormone with distinctive estrogen-receptoOvarian hormone loss at midlife affects more than reproductive tissues. Dr. Voskuhl’s preclinical research linked loss of estrogen receptor beta signaling in astrocytes with hippocampal memory impairment, giving scientists a biological mechanism to investigate for the cognitive changes many women report.r activity, including preferential activity at estrogen receptor beta. My work examines how those receptor pathways may support neural cells and influence inflammation—one reason different estrogens should not be treated as interchangeable.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
How does estriol’s receptor activity differ from other forms of estrogen?
Estriol is a pregnancy hormone with distinctive estrogen-receptor activity, including preferential activity at estrogen receptor beta. My work examines how those receptor pathways may support neural cells and influence inflammation—one reason different estrogens should not be treated as interchangeable.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
When does the critical window for protecting cognitive health begin?
My research focuses on what changes when ovarian hormones are lost at midlife. It treats the perimenopause-to-menopause transition as an important window for studying—and potentially preserving—cognitive function.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
Why do women and their doctors still have so few evidence-backed choices?
Menopause research and care have historically centered on reproductive symptoms and hot flashes, while cognition has received less attention as a primary outcome. My agenda calls for rigorous brain-health research so women and clinicians can make decisions from stronger evidence and more than an all-or-nothing set of options.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
What might menopause reveal about cognitive risk later in life?
Menopause offers researchers a defined biological transition for studying how hormone loss, metabolism, inflammation, and memory interact. Those pathways may help illuminate later-life cognitive risk, including questions around Alzheimer’s disease, but they remain an active area of research rather than an individual prediction.
DR. VOSKUHL’S RESEARCH PERSPECTIVE
Brain-First Menopause Care
The science began in the lab. It continues with you.
Learn how CleopatraRX translates Dr. Voskuhl's research into personalized care designed around cognitive health.
Brain-First Menopause Care
The science began in the lab. It continues with you.
Learn how CleopatraRX translates Dr. Voskuhl's research into personalized care designed around cognitive health.