Canceling Menopause: Longevity Science Challenges The Reproductive Status Quo3 months, 3 weeks ago
Posted on Feb 08, 2023, 1 p.m.
Society has long accepted the natural decline of fertility and the onset of menopause as an inevitable part of life for women. An increased risk for age-related disease, disability, and cognitive decline, that just comes with the territory. However, the status quo of shifting hormone levels accompanied by cumbersome symptoms ranging from relatively mild (night sweats, irregular bleeding) to potentially fatal (heart disease, dementia) is now being questioned.
Humans are unique in that we are one of only five species that experience menopause and the only one that lives on land. Our closest cousins, chimpanzees, do not stop their reproductive cycles until near death. So why must we?
The truth is, there is no fundamental biological reason that requires women to begin losing the eggs essential to their future fertility before they even exit the womb. From 7 million eggs at 26 weeks of gestation down to 1 million at the time of birth, the number of eggs females carry begins to decrease exponentially, dwindling to 1,000 by age 51.
It’s worth noting that egg quality decreases with age, too: chromosomal defects increase by 0.5% each month after 35 years old, so a woman in her early 40s will likely have abnormalities in three-quarters of her remaining eggs.
While in utero and weighing approximately six large carrots (760g), a female’s fertility peaks. But does that make any evolutionary sense?
Rethinking Menopause: Perhaps It’s Time to Cancel It Altogether
“I did not consent to this thing called menopause, and I do not want to go through it.” —Jennifer Garrison
Recent research in ovarian science aims to extend fertility and longevity by delaying menopause, and a small but growing number of scientists believe it’s time to “cancel menopause” – or at least delay it substantially.
Despite human life expectancy extending by decades, the average age of menopause has not even budged. The hypothesis is that by extending female fertility, we can postpone the onset of age-related health problems, better understand longevity, and do wonders for women’s quality of life.
While there is still much to be understood and researched, it’s clear that the idea of canceling menopause is not as far-fetched as it may seem. It’s worth exploring the possibility of preserving fertility and protecting against the risks of age-related diseases.
A recent report published by NEO.LIFE, an online magazine dedicated to the biotechnology beat, delves into the exciting and rapidly developing field of ending menopause. The text closely examines research efforts in this area, shedding light on the pressing questions, latest developments, and expert opinions on this topic. It is an in-depth look at the possibilities and potential implications of canceling menopause and the work being done to make it a reality.
Advancing Reproductive Longevity: The Pioneering Research of Jennifer Garrison
“[…] The scientists pursuing this goal (many of them pre-menopausal women) believe so fiercely in their pursuit that they’re willing to take on any challenges – be they from Mother Nature or their fellow man.” —NEO.LIFE
As scientists and researchers continue to explore the possibilities of extending fertility, one researcher leading the initiative is Jennifer Garrison, assistant professor at The Buck Institute for Research on Aging in California.
Garrison’s research initially focused on understanding the role of neuropeptides, fragments of proteins in the brain that act as long-range biochemical signals, and how they influence systemic aging in C. elegans worms. But upon discovering a neurologic connection to the reproductive system, she expanded her focus to understanding how these signals change in humans as part of the menstrual cycle and aging process.
This shift in focus has placed her at the forefront of the field of female reproductive longevity, building this area of scientific research from the ground up.
Asking the Right Questions: Understanding the Mysteries of Ovarian Aging
“That awareness is changing now, as more researchers begin to ask why women’s age at menopause has barely budged over the past century even as our lifespans grew decades longer.” —NEO.LIFE
As a subject of study, reproductive longevity is a relatively new field, and the pool of researchers studying ovarian aging is small. Unfortunately, persistent societal taboos, systemic sex bias in biomedical research, and massive underfunding for research have limited progress in addressing these problems to date. However, as more researchers question the stagnancy of the female fertility timeline, awareness and interest in this field are increasing.
Pioneering researchers like Jennifer Garrison and her colleagues are at the forefront of this field, asking questions no one has dared – or thought of – asking before.
Why do women stop ovulating at a certain point in life? And why do we need menopause – or if we even do at all?
Among the questions that Garrison and her colleagues aim to answer is why the ovaries age so much earlier than the rest of the body, becoming “basically geriatric” when a woman is in her thirties. By gaining a deeper understanding of the aging process in the ovaries, they hope to extrapolate this knowledge to better understand aging in the rest of the body and ultimately to identify and reverse the causes of aging and disease in both men and women.
Addressing Health Inequality: The Impact of Menopause on Women’s Lives
“This is an important battle for humanity and productivity and women.” —NEO.LIFE
The reality is that menopause significantly impacts women’s professional advancement, health outcomes, and well-being. Dina Radenkovic, MD, a longevity physician, and entrepreneur, highlights the existing barriers to women’s professional advancement in the report, specifically the timeline forced upon them by their reproductive system.
Just as women hit peak career growth, they either step away from their jobs to become mothers or grapple with the risk of losing their chance to give birth. And when they finally attain leadership roles by their forties or fifties, menopause hits.
A 2018 research review found that menopause substantially impedes women’s quality of life and work performance and disproportionately affects women of lower socioeconomic status.
According to the NIH, 75% of women experience some of the most common menopausal symptoms, including hot flashes, night sweats, palpitations, and migraines; these can last an average of more than seven years. Although, those are not the only side effects of fertility’s end. Up to 60% of women suffer from urogenital symptoms such as vaginal dryness, painful sex, incontinence, and decreased libido, and 45% contend with mental health symptoms such as anxiety, depression, sleep disturbance, and difficulty concentrating.
Research has found that without treatment, the most common menopause symptoms cost more than $2,100 in healthcare and lost work productivity per woman per year.
The impact of menopause on health doesn’t end with the hormonal transition. Instead, it begins a new chapter of disease, disability, and death. Fluctuating erratically during perimenopause, estrogen levels collapse to near zero during menopause. This shift causes a surge in risk for dementia, metabolic disorders, and depression. Half of postmenopausal women develop osteoporosis, more than double the rate found in men, while their risk for cardiovascular events quadruples.
A study conducted by the United Kingdom’s government found that, while women in the U.K. live longer than men, they spend more years in poor health. Perhaps the most substantial testimony to the correlation between menopause and longevity is the well-established fact that women who experience menopause later in life tend to live longer. In short, menopause accelerates the aging process: indirectly by interfering with biological cycles and directly by speeding up cellular aging directly by at least 6%.
Rather than being viewed as a crisis, the increased risk of disease and death that comes post-menopause has been deemed a natural component of the aging process.
Investing in Women’s Health: Funding Female-Focused Research
“To cancel menopause, experts say, we will have to overcome the longstanding underfunding of women’s health research and the obscurity of the fledgling field of female reproductive longevity.” —NEO.LIFE
Unfortunately, only 1% of healthcare research dollars are directed toward women’s health despite impacting over half of the global population. Neglecting women in research has long disadvantaged them, with one glaring consequence being that over 80% of drugs have been pulled from the market due to safety concerns about adverse effects on women. Another cost of ignoring females in biomedical research? The discrepancy in outcomes between men and women infected with COVID-19.
Women control 80% of healthcare spending, and investors are starting to recognize the vast opportunities in this massively underserved market.
Kristina Simmons, Founder and Managing Partner of Overwater Ventures, who previously worked at Lululemon and Khosla Ventures, views the “menopause space” as an extensive opportunity. “Women’s health is one of the highest potential and most important investment areas,” she told Forbes in a 2022 interview. “It’s been underfunded, and because of the acceleration of science/tech, now is the time.”
The so-called menopause market was valued at $14.7 billion in 2020, with an expected annual growth rate of 5.7%. A forecasted 1 billion women (or more) will be in menopause by 2025, contributing to healthcare expenditure of $600 billion and a cost of productivity loss of $150 billion per annum.
Investing in research in menopause and reproductive longevity has the potential not only to help extend fertility and improve health outcomes for women but also to drive advancements in the global longevity sector and anti-aging interventions for both sexes.
Garrison and her colleagues are leading the charge in this field, pushing for more funding and support for research that can help us better understand the intricacies of reproductive longevity and the potential ways of delaying or canceling it.
Assessing and Challenging: The Implications of Extending Fertility
“So, who’s ready to sign up for extended fertility and a healthier later life? Actually, not everyone.”—NEO.LIFE
Experts in the reproductive longevity field are discussing the implications of extending fertility for women, their health, and society. Some suggest that the solution Garrison and her colleagues are working toward already exists in the form of hormone therapy. If more women started hormone therapy earlier, before the bodily damage done by dwindling estrogen, and sustained it longer, they could slow the onset of menopause, extend their fertile period, and potentially reap the health benefits associated with delayed menopause.
However, there are also concerns about the risks of elongating fertility, such as a higher risk of ovarian cancer, endometriosis, and anemia. Those against reproductive longevity argue that artificially extending the fertile timeline could result in women having babies in their 70s or suffering from “forever periods” – both undesirable outcomes.
Somewhere between extending fertility by five years and ending the menopause transition entirely lies the potential for a happy medium. It involves carefully balancing risks and benefits in favor of an increased female healthspan, synchronizing the pre-menopause period more closely with life expectancy to provide women with a few more years of ovarian function.
Although female reproductive longevity is a complex issue that requires much further research and consideration, the ability to decrease the risks of age-related diseases and all-cause mortality while improving women’s health and quality of life is a goal worth striving for.
Moving Forward: The Future of Female Reproductive Longevity
“Should we overcome our own evolutionary programming? And if it’s possible, can we make it safe? No one knows for sure what will happen if we re-score the symphony of biochemical signals that orchestrate and flow from a woman’s menstrual cycle, because no one’s ever done it before.” —NEO.LIFE
Garrison’s work is shedding new light on the mechanisms of aging and fertility, and her research has the potential to pave the way for new treatments and therapies that can extend fertility. Researchers hope to empower women with more options and parity in their reproductive health choices.
Driven by growing attention from the scientific field, multiple forces are converging to support the work in menopause extension. Researchers predict that the discoveries made in reproductive longevity research could be a key to unlocking insights about human aging more broadly. As a result, there is a keen interest in aging research among government funders and private investors, the new engine of the Buck Institute’s center, and other key stakeholders (such as pre-menopausal women).
The burgeoning scientific field is intensely quickening its pace, worrying some researchers and encouraging others like Jennifer Garrison, who views this as a positive indicator of transformation, drawing in funding, awareness, and collaborative expertise.
As investment in this research continues to grow, we can expect significant advancements in our understanding and ability to control the aging process and menopause in the near future.
2023 could be a historic moment: The conversation about women’s health will advance, scientific breakthroughs will deepen our understanding of reproductive health, and women worldwide will inch closer to parity.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement.
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