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In medicine, the male body was long regarded as the standard, whilst women were excluded from many clinical trials right up until the 1990s – partly out of concern that hormonal fluctuations might “complicate” research findings. The result is a data gap that is still evident today and has a significant impact on the diagnosis, treatment and healthcare of women. Every year on 28 May, the International Day of Action for Women’s Health highlights the fact that the right to sexual and reproductive health remains far from a given for many women.
In their research within the Leipzig Center of Metabolism (LeiCeM) Cluster of Excellence at Leipzig University, the scientists Professor Julia Sacher and PD Dr Veronica Witte place particular emphasis on sex and gender in order to improve healthcare for women and to reflect the biological diversity of all genders more effectively.
To this day, women remain underrepresented in biomedical research – with very tangible consequences for more than half the population: diseases often present differently in women, are diagnosed later, and are in some cases not treated adequately. Within the Leipzig Center of Metabolism (LeiCeM) Cluster of Excellence, Professor Julia Sacher and PD Dr Veronica Witte are working to gradually close this gap in healthcare provision between men and women. Sacher is Professor of Cognitive Neuroendocrinology at the Clinic for Cognitive Neurology at the University of Leipzig Medical Center and in the Department of Neurology at the Max Planck Institute for Human Cognitive and Brain Sciences. Witte heads a research group at the Clinic for Cognitive Neurology at Leipzig University Medicine and in the Department of Neurology at the Max Planck Institute for Human Cognitive and Brain Sciences. Both researchers emphasise that hormonal differences between the sexes cannot be ignored in modern medical research, as they affect almost every area of health – from metabolism and the cardiovascular system to the brain.
Focusing on hormonal transition phases in women’s bodies
“Biological sex, but also the way society treats women and men, demonstrably influences how the brain and body respond to stress, medication and disease. If we ignore these factors, we overlook important biological relationships and signals. Taking complexity and diversity into account makes research more precise – and that is exactly what modern medicine should be about,” says Sacher. She investigates the interactions between the nervous system and the endocrine system. Within the Leipzig Center of Metabolism (LeiCeM) Cluster of Excellence, she investigates how different metabolic risk profiles influence brain health in women and men at different stages of life. In particular, her research focuses on hormonal transition phases in women’s bodies, such as the menstrual cycle, pregnancy and menopause.
“Hormones are among the most important biological signals of neuroplasticity. They influence how the brain is organised, adapts and ages, and reflect the brain’s enormous capacity for adaptation,” says Sacher. Using a particularly effective MRI technique, she and her team were able to show that key memory regions of the brain undergo structural changes in step with hormonal fluctuations throughout the menstrual cycle. At the same time, it is becoming increasingly clear that hormonal health, metabolic health, and cardiovascular and brain health are closely interconnected.
Hormonal transitions can also be associated with an increased risk of certain conditions, including depressive episodes and dementia. The female sex hormone oestrogen appears to play a protective role for the brain and memory – particularly in interaction with risk factors for metabolic disorders such as increased visceral fat accumulation. “The menopause is therefore a crucial period in determining how we age cognitively. Yet less than one per cent of the neuroimaging literature currently addresses women’s health. This represents an enormous opportunity to gain a better understanding of brain health and of individual risk factors for neurological and psychiatric disorders,” explains Sacher.
INFLAME study examines women in perimenopause
PD Dr Veronica Witte also places particular emphasis on hormonal transition phases in her research. Among other things, she investigates how gut bacteria influence how we eat and our dietary choices – and how diet and lifestyle, in turn, can affect the structure and function of the brain.
“There is evidence that certain gut bacteria may reduce the permeability of the blood-brain barrier through various signalling pathways. This, in turn, could have positive effects on the supply and function of nerve cells, which form the basis of our thinking,” explains Witte. It follows that certain nutrients may help strengthen beneficial gut bacteria and thereby preserve the structure and function of the brain over the long term.
Through the INFLAME study, which Witte is leading, she hopes to investigate precisely this in women undergoing perimenopause – the hormonal transition phase preceding menopause. “During this phase, women undergo a range of complex hormonal changes and adaptations that affect almost every organ, including the brain.” It is assumed that the protective effect of oestrogen on blood vessels, insulin sensitivity and fat distribution diminishes, thereby increasing the risk of metabolic disorders such as obesity, high blood pressure and diabetes. Female participants are still being sought for the INFLAME study.
Why sex-specific medicine is gaining increasing importance is also the focus of the UKL Health Forum 2026, taking place on Saturday, 30 May. There, Professors Julia Sacher and Ulrich Laufs will discuss the question: “Should medicine be designed differently for women and men?”
The Leipzig Center of Metabolism (LeiCeM) is a Cluster of Excellence at Leipzig University, funded under the Excellence Strategy of the German federal and state governments. LeiCeM is being supported from 1 January 2026 for a period of seven years. Researchers in the cluster investigate how metabolic processes connect the body and brain, and how these insights can inform personalised approaches to prevention and treatment. The interdisciplinary approach integrates molecular, cellular, and systems-level basic research with clinical studies and data-driven methods, including artificial intelligence. The aim is to accelerate the translation of research findings into clinical practice and to develop new therapeutic strategies for conditions such as diabetes, obesity, lipid metabolism disorders, and fatty liver disease.
Author: Karolin Breitschädel
Translation: Matthew Rockey
PD Dr. Veronica Witte
Telephone: +49 341 97-24990
EMail: veronica.witte@medizin.uni-leipzig.de
Prof. Dr. med. Julia Sacher
Telephone: +49 341 97-24989
EMail: julia.sacher@medizin.uni-leipzig.de
https://www.uni-leipzig.de/en/leipzig-center-of-metabolism
PD Dr. Veronica Witte
Source: Antje Gildemeister
Copyright: Leipzig University
Prof. Dr. med. Julia Sacher
Source: Antje Gildemeister
Copyright: Leipzig University
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