Delaying Menopause for Longevity

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While women tend to live longer lives than men on average, the quality of their lives are more at risk, with women spending an average of nine years in poor health. Despite them living longer years, it is essential to find a way to better align their health-span with their lifespan. As the ovaries are connected to nearly every part of a woman’s well-being and longevity, science has become increasingly aware of the importance of the role of the ovaries, beyond their ability to be essential for reproduction.

Menopause is a pivotal time for all women, as this is when the ovaries will stop functioning with secondary effects on the performance of the other organ systems. Menopause generally occurs for women between the ages 45-55 years old and brings about a wide array of symptoms. Symptoms can range from hot flashes, irritability, mood swings, depression, brain fog, skin issues, trouble sleeping, and more. The neurological symptoms a woman can experience during menopause highlights the influence that the ovaries have on the brain. Hormone replace therapy (HRT), e.g. providing the body with sufficient sex hormones beyond menopause has been evaluated as a strategy to prevent or minimize the effects of declining ovarian estrogen production. However potential serious side effects associated with this treatment strategy have prevented its widespread adoption (for more information about HRT, see Mind Gut Conversation podcast episode with Dr. Ronda Voskul, here).

The ovaries are the only organ that is understood to essentially fail at a set point in life. However, when the ovaries begin to decline, so do the other organ systems such as the heart and the brain and scientists have posed the question of whether prolonging the functioning of the ovaries could also have the potential to delay the decline of other organ systems. While the connections made between ovarian function and healthy human longevity thus far are mainly correlational, it is logical to ask if delaying menopause could be a key to increasing the health span of women.

“Scientists pose the question of whether prolonging the functioning of the ovaries could also have the potential to delay the decline of other organ systems.”

Correlational studies are unable to determine if ovaries are the drivers of longevity or if there is something else driving the aging process that in response causes the ovaries to stop functioning. In other words, is ovarian function simply a biomarker of health or if the decline of the ovary is resulting in worse health outcomes.

The ovaries communicate with virtually every organ system and strongly influence their functioning by sending multiple signals throughout the body primarily in the form of sex hormones, such as estrogen and progesterone and their many metabolites. Some of these sex hormone metabolites are produced by microbes in the gut from food containing so called phytoestrogens (like soybeans and tofu) and from estrogens excreted by the liver into the intestine. Depending on the individual composition of the gut microbiome, this reabsorbed fraction of the estrogen pool greatly varies between women, a potential explanation of the wide range of post-menopausal symptoms.

Ovarian dysfunction is not only a problem seen in women going through menopause during midlife. In fact, women of a reproductive age may be dealing with abnormal ovarian function as well. This can manifest as polycystic ovarian syndrome (PCOS), a common hormonal condition which has a significant effect on the physical and mental health of women. PCOS increases a young women’s risk of developing metabolic conditions, such as type 2 diabetes, cardiovascular disease, and mental health problems.

“In a study performed in laboratory mice, scientists found that they could increase the lifespan of an older mouse by transplanting an ovary from a younger mouse.”

While a better understanding of the human lifespan of the ovaries is still needed, animal studies point to the fact that the ovaries may play a key role in the aging process. In a study performed in laboratory mice, scientists found that they could increase the lifespan of an older mouse by transplanting an ovary from a younger mouse. These findings lead scientists to explore various ways of prolonging the lifespan of the ovaries in women to increase their longevity.

Various startup companies and researchers are working to find new ways in which extending ovarian function and increasing ovarian reserve may be possible. One company, Oviva Therapeutics, has been testing a treatment to control the loss of eggs during each menstrual cycle. The idea behind their strategy is that if women were to lose less eggs, they can then prolong ovarian function. Even though an intervention like this could possibly extend fertility, the goal of extending ovarian function is not to draw out a woman’s fertile years, but rather to increase a women’s health span by ensuring full functioning of essential organ systems.

“A human clinical trial is ongoing, and so far the drug appears to have an impact…”

Researchers at Columbia University have also been working on a clinical trial to understand how to slow the process of a woman losing her eggs. They have been doing this through the immune-suppressant drug, rapamycin, which has been evaluated for its ability to increase longevity. Rapamycin has shown to increase ovarian function in mice and it has proven to influence the number of eggs that mature every month. A human clinical trial is ongoing, and so far the drug appears to have an impact, as there are differences in the ovarian reserves between the woman who are taking the drug and those who are taking a placebo.

While more research and technology are needed to fully understand the relationship between ovarian function and longevity in women, it is clear that the ovaries are a key factor when it comes to aging. There needs to be more clarity on whether ovarian dysfunction prompts aging or if it is another factor that is driving the aging process. Future research and technologies are promising when it comes to providing women with better life outcomes and an increased health span.

Amanda Johnson is a recent graduate from the University of Southern California where she received her degree in Psychology. In addition to her university studies, she earned her Integrative Nutrition Health Coach certification from the Institute of Integrative Nutrition (IIN).

This article was reviewed and approved by Emeran Mayer, MD