In March, U.S. First Lady Jill Biden announced a new White House initiative for women’s health that highlighted a seemingly unknown research question: What if it were possible to delay menopause and all the health risks associated with it?
This question comes from an area of research that has begun to gain attention in recent years, as scientists studying women’s longevity and health have concluded that the female reproductive system is much more than a simple baby factory. The ovaries, in particular, seem to be linked to almost every aspect of a woman’s health.
In addition, they suddenly stop performing their main function in middle age. Once this happens, a woman enters menopause, which accelerates her aging and the decline of other organs, such as the heart and brain. Although women, on average, live longer than men, they also spend more time with illness or disability.
Ovaries are “the only human organ that we accept will one day fail,” says Rene Wegrzyn, director of the Health Advanced Research Projects Agency, a US government agency tasked with leading Jill Biden’s mission. “Actually, it’s a bit strange to accept that.”
The truncated lifespan of the ovaries is precisely what makes them such a promising experimental site. Researchers believe that prolonging their function and better matching their lifespan with other organs could change the course of women’s health and longevity research in general.
Wegrzyn says he hopes the White House initiative, in which researchers and startups compete for a slice of the program’s $100 million budget, will shed light on the relationship between menopause and longevity, while attracting more funding and talent to the field.
“If you don’t take into account the function of your ovaries during aging, you’re missing an opportunity,” says Jennifer Garrison, MD, assistant professor at the Buck Institute for Research on Aging.
Ovaries and aging
The ovaries act as a control center for “a complex signaling network in a woman’s body,” Garrison explains. Through hormones such as estrogen and progesterone, as well as other chemicals, the ovaries communicate with and influence almost every other organ. Scientists still don’t know exactly how they do it, but what they do know is that when the ovaries stop working normally, all kinds of problems arise. In young women, for example, this can manifest as polycystic ovary syndrome, which increases the risk of metabolic disease, heart disease and mental health problems, among others.
As a woman runs out of eggs, eventually leading to menopause, the chemical communications from the ovaries appear to stop. This is consistent with an increased risk of dementia, cardiovascular disease, osteoporosis and other diseases associated with aging. The earlier a woman enters this stage of life, the greater her risk of these conditions, and the shorter her life span is likely to be.
In the case of women who enter menopause early due to the removal of their ovaries, the risk of chronic diseases is greater. According to Stephanie Faubion, MD, medical director of the Menopause Society, this suggests that even after the ovaries stop releasing eggs at this stage of life, they may still protect a woman’s overall health in some way. Just it is not clear how.
Delaying menopause can prolong life.
There is some evidence, especially in animals, to suggest that prolonging ovarian function may improve health and increase longevity. In mice, for example, transplanting ovaries from a younger animal to an older animal extends the lifespan of the older mouse.
After the ovaries stop releasing eggs at this stage of life, they can continue to protect the woman’s overall health in some way.
Scientists are now experimenting with different ways to prolong ovarian function and delay the onset of menopause in humans.
Oviva Therapeutics is testing mice and cats to see if a pharmaceutical version of anti-Müllerian hormone (AMH), which regulates the number of follicles that mature in each menstrual cycle, can be used to reduce egg loss. (A woman typically loses dozens of eggs each cycle, although in most cases only one ends up ovulating.)
You have to think of AMH as “a porous tissue covering the ovary,” explains Daisy Robinton, co-founder and CEO of Oviva, which is fighting to get some of the initiative’s funding from the White House. The level of AMH determines the size of the holes in the fabric; if there are big holes (in other words, low AMH), more eggs may come out in each cycle. But if there are only small holes (in other words, high AMH), fewer eggs may come out.
The idea, explains Robinton, is that if a woman loses fewer of these sex cells, she can maintain her ovarian reserves and function longer.
A clinical trial being conducted at Columbia University is also trying to slow the rate of egg loss. The study tests the use of an immunosuppressive drug called rapamycin — which is used to prevent organ transplant rejection and has become a favorite of the longevity movement — in women ages 35 to 45 to see how it affects your ovarian reserve. Rapamycin affects the number of eggs that mature each month, and the drug has been shown in mice to prolong ovarian function.
The study is still ongoing, and researchers do not know which participants received the drug or a placebo, but the lead scientist on the trial, S. Zev Williams, points out that two patterns have actually emerged: Some women appear to have normal ovarian insufficiency. He points out that the reserve, which can be measured through ultrasound and AMH levels, but in other cases “seems to have been altered,” adding: “So it is promising.”
Experts were clear when they stated that the goal of this type of research is not to prolong women’s menstruation indefinitely, nor to make pregnancy possible at age 70, although it is true that treatments can prolong fertility.
Copyrights New York times
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