Menopause: New Research and Developments
An e-card from Someecards reads, “’Menopause really isn’t that bad,’ said no woman ever.” Another one says, “Oh, I understand it now…Menopause is just puberty’s evil older sister.”
We laugh because we know it’s true, whether or not we’ve experienced “the change.” New research and developments in understanding menopause and treatment, however, may make this life transition a little bit easier.
Menopause – which typically happens between the ages of 45 and 55, with an average age of onset of 51 – is basically when the menstrual cycle ends due to hormone changes. In other words, buh-bye fertility.
Here are some of the latest highlights in the menopause field:
Heart risk and early menopause
According to a study in JAMA Cardiology, as many as 10 percent of women experience natural menopause by the age of 45. This is considered early onset menopause and the study found that this is associated with an increased risk for cardiovascular disease and death. It’s theorized that an earlier loss of ovarian function may cause hormonal changes which in turn lead to inflammation and vascular damage.
The study’s lead author recommends that women who reach menopause early be screened for medical conditions like hypertension, high cholesterol, and diabetes, as treating these disorders early will reduce their risk.
Indeed, other research has found that women who develop insulin resistance during perimenopause or menopause are at higher risk for these conditions also. Insulin resistance may also promote cell proliferation, thus increasing breast cancer, says Dr. JoAnn Pinkerton, MD, NCMP, Executive Director of the North American Menopause Society.
Hot flashes and genes
Hot flashes are the most recognized menopausal symptom, but not everyone experiences them. More than 70 percent of women experience hot flashes and night sweats, known as menopausal vasomotor symptoms.
According to a press release, UCLA-led researchers have found gene variants that affect a receptor in the brain that regulates estrogen release and is present across all ethnicities. “It appears that women who have these variants are more likely to have hot flashes than women who lack them,” the study in Menopause says. This will help researchers develop new treatments for this symptom.
Other implications of finding these gene variants include learning that hot flashes likely originate in the brain, which means that women’s brain health and cognition may be affected, says Dr. Rebecca Thurston, PhD, Professor of Psychiatry and Director, Women’s Biobehavioral Health Laboratory at the University of Pittsburgh. Dr. Thurston was recently recognized for her contributions to the field of menopause science. She just received a large National Institutes of Health grant to study this further.
Dr. Thurston says that not only do hot flashes/night sweats start earlier and last longer than previously thought, but very frequent and/or early hot flashes may potentially be the highest cardiovascular disease risk.
Sleepless nights and aging
UCLA researchers have found that menopause accelerates biological aging, and that insomnia – a common menopausal symptom – also has a clear association with rapid aging. Women’s risk for aging-related diseases, cardiovascular health, and earlier death could therefore be increased.
In the press release, a senior author talks about how scientists have disagreed for decades about whether menopause causes aging or if aging causes menopause. The study published in the Proceedings of the National Academy of Sciences is the first to show that menopause makes you age faster.
The study found that menopause speeds up cellular aging by an average of six percent, which doesn’t sound like much but adds up over a woman’s lifespan. “The younger a woman is when she enters menopause, the faster her blood ages,” author Morgan Levine says, “which is significant because a person’s blood may mirror what’s happening in other parts of the body, which could have implications for death and disease risk.”
Women are at greater risk of depression symptoms when their periods end during the early postmenopausal period than if they end before age 45. This is independent of sociodemographic and health factors, Dr. Pinkerton says, as multiple psychosocial and health factors are associated with a greater risk of depression. Women with a depression history prior to midlife are at greater risk for major depression during and after the menopause transition, she says.
Other research benefits
Symptoms like hot flashes and insomnia typically affect most women years before heart problems manifest. With this new information, the hope is that women will be able to change their health behavior and lessen their risks.
Dr. Thurston has talked about how many of our models of cardiovascular disease are based on a male model. This means playing a game of catch-up to characterize cardiovascular disease and its risk factors in women. She says there may be a subset of risk factors unique to women related to menopause (and pregnancy).
An especially significant development is that researchers won’t have to follow patients for years to track their health and occurrence of diseases, the UCLA press release states. Now they can use a “genetic biological clock,” called epigenetics, which could drastically reduce the length and costs of clinical trials and make benefits available sooner.
Additionally, “learning that menopause affects biological age is very important in understanding the benefits and risks of hormone therapy at menopause, which appears very important for women with early menopause to prevent future health risks,” says Dr. Pinkerton.
Right now, women need more options, Dr. Thurston says. “The menopause transition can be a time of impaired quality of life for many women, and our options to help women through this remain somewhat limited,” she adds. “Women need more options, [and] menopause is a time often directly before the onset of clinical events. So it may be a time that women can make changes in their lives that not only benefit their quality of life but also their physical health as they age.”