Your Genes, Your Body Image, and a Vacuum for Your Vagina

Key Takeaways

• ✦Women who carry the APOE4 gene variant may experience a more pronounced disruption in how brain cells switch fuel sources during the menopause transition — a shift that some researchers connect to elevated Alzheimer's risk in this population.
• ✦The brain's preferred fuel source shifts from glucose to ketone-based metabolism during menopause; APOE4 appears to interfere with that adaptive process, according to a 2026 study by Wang et al.
• ✦Shania Twain publicly described menopause as having improved her relationship with her body — a notable counternarrative to the predominantly negative media framing of this life stage.
• ✦A small feasibility pilot (NAMS Journal, 2026) found that a negative pressure device called the VITA AV system was tolerated by women with GSM, with no safety issues and self-reported symptom improvements — but the sample was small and controlled trials haven't been done yet.
• ✦GSM (genitourinary syndrome of menopause) affects an estimated 50–70% of postmenopausal women but remains significantly under-discussed and undertreated; the treatment pipeline beyond topical estrogen is genuinely expanding.