Will delaying menopause keep women healthier for longer? Experts are trying to figure that out.
As The New York Times reports, the White House earlier this year announced an initiative to determine whether pushing back menopause — in short, the process by which a woman's ovaries fail, typically during midlife — might extend women's quality of life and health.
As the NYT notes, a woman's reproductive system has implications far beyond reproduction. When ovaries stop working, that loss of a pair of critical organs is felt throughout the rest of the body. Postmenopausal women are at higher risk of heart attack, and research shows that in the first ten years postmenopause, their risk of stroke doubles; postmenopausal women are also likely to develop conditions including but not limited to osteoporosis, dementia, migraines, and mental health issues.
Enacted by First Lady Jill Biden, the $100 million White House initiative — dubbed the Executive Order on Advancing Women's Health Research and Innovation — is seeking to investigate the link between a woman's reproductive organs, menopause, and longevity, among other efforts. And according to the NYT, researchers are lining up to help.
The ovaries are the "only organ in humans that we just accept will fail one day," Renee Wegrzyn, director of the Advanced Research Projects Agency for Health — which, per the NYT, is tasked with leading the project — told the paper. "It's actually kind of wild that we all just accept that."
"If you don't think about ovarian function during aging," added Buck Institute for Research on Aging assistant professor Jennifer Garrison, "then you're kind of missing the boat."
Ovaries play an essential role in creating and regulating hormones like progesterone and estrogen. Put simply, hormones are messengers; they're designed to carry instructions and information throughout the body, and the ovaries manage that process. But once a woman's egg supply is depleted, ovaries effectively close up shop, derailing this important and deeply complex messaging system — and this process of egg depletion and eventual ovary-shuttering is what we understand as menopause. (It's also worth noting that misfiring ovaries can have consequences for younger women, for example those who suffer with polycystic ovarian syndrome, or PCOS.) Once that process is complete, an individual is postmenopausal.
And yet, surprisingly little is known about the nature of this uncomfortable and often very consequential process.
For one thing, why do ovaries tend to time out before other organs do? How much of that process is commanded by genetics versus environmental conditions? As the NYT points out, factors including smoking and stress are known to contribute to earlier menopause, as do autoimmune diseases and certain treatments like chemo and radiation. There are also measured racial disparities between Black and Hispanic women and white women, the latter of whom tend to go into menopause later.
"Is the ovary just a marker of overall health? Or is it that the ovary is timing out and causing poor health?" Stephanie Faubion, the medical director for the Menopause Society, told the NYT. "I mean, it's chicken-egg."
Researchers are currently testing several possible means of slowing menopause down. Per the NYT, one idea is to simply slow the process of egg depletion. One method being tested is the introduction of a synthetic version of anti-Müllerian hormone (AMH), a chemical that plays a critical role in egg release. Elsewhere, researchers are also testing whether certain drugs like the immunosuppressant drug rapamycin might work to slow ovary aging.
Speaking to the NYT, researchers were careful to emphasize that the research centers on longevity and overall health, not just reproductive capacity.
Indeed, to that end, it is striking that medicine and the broader culture have accepted menopause — despite its clear and detrimental impact on women's health — as a reality of aging for women, and not as a complicated and widespread instance of organ failure that could be more effectively mitigated. It's almost as if we systemically undervalue older women or something!
That in mind, that this initiative exists at all feels like a big deal. Hopefully, the impact of the resulting research will be a better understanding of women's bodies, lives, and health — and, not to mention, some extra validation towards the notion that women are actually people beyond a functioning womb.
More on menopause: Scientists Working on Drug to Indefinitely Delay Menopause
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