As published in AthenaDAO's Reproductive Health Report.
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What if menopause were cancelled?
Dr Jennifer Garrison, a scientist in the field of reproductive longevity, says that interviewers often ask her this question. It sounds sensational, but detracts from the real message she is trying to broadcast: women’s health, and in particular women’s reproductive health, has been ignored by science and medicine for too long. She wants to know why ovaries age faster than the rest of a woman’s body and is excited about the health improvements the answer to that question could bring for women of all ages. It could also, she says, teach us about the mysteries of aging, and the secrets to healthy longevity.
“My goal is to have this be top of mind for every single person on the planet,” says Dr Garrison, who is co-founder and director of the Global Consortium for Reproductive Longevity & Equality and an assistant professor at the Buck Institute for Research on Aging near San Francisco. “We are talking about half of the population: if we can understand why ovaries age prematurely, I think we can shed light on all aspects of aging.” This, she explains, would have profound economic impacts, “because of the health risks of menopause, the cost of medical care, and the loss of productivity that happens for many women at perimenopause.”
Perimenopause symptoms can have a dramatic impact on a woman’s ability to function, she says. At the Buck Institute, Dr Garrison runs a research lab where: “We are trying to understand how a breakdown in homeostatic circuits in the brain drive systemic ageing.” A chemist and neuroscientist by training, she explains the large picture by how she looks at the small picture. “I’ve always been fascinated by neuropeptides, and how the brain uses these bioactive peptides as a mode of communication.” She likens the system to the brain’s Wi-Fi.
“I think about every piece of reproductive function as being controlled by the brain.” Fertility and healthy aging “depend on neuronal pathways that both instruct and listen to feedback from reproductive tissues through a complex orchestra of hormonal signalling.” Understanding how that conversation changes with age, she says, could also give insights into fertility and reproductive health in young women.
She wants to make it clear that the goal is to provide women the opportunity to choose if and when they have biological children, and to maintain their health into old age. This mission however, can be mischaracterized with headlines about canceling menopause. People often react, she says, by saying “I don’t want to have periods until I’m 70! I don’t want to have a baby at 60!” The key point to understand is that having a baby requires far more than functioning ovaries.
It all comes down to being honest about a reality women have to contend with: “When ovaries stop producing hormones, that increases health risks, cognitive decline, dementia, metabolic changes, depression and osteoporosis.” Menopause, she adds, quadruples your risk of cardiac events. “It makes a woman’s body age faster than men,” because of this, she says, “women spend a significantly longer portion of their lives in poor health.”
Understanding what factors cause menopause, and the related health outcomes that come with it, is a way into the future still. “In the short term, we need to redefine the diagnostics we have, rethink the field and change the narrative in terms of biomarkers.” We also need to define a more comprehensive view of reproductive health span.
Ovarian aging is affected by a lot of factors, including genetics, BMI, environmental factors, therapies and health conditions. Progress, she says, lies in doing research to get at the underlying causes of reproductive decline in women. To tackle this issue, the GCRLE is providing much needed research funding to scientists all over the world, and building the ecosystem around female reproductive longevity. Meanwhile, Dr. Garrison says advocacy is key: “We need to galvanize and empower an army to help us direct funding and attention to this critical issue.”
Speaking about the future, and the possibilities the research could lead to, gets Dr. Garrison excited. As a scientist she is very careful with her words. But when she answers a question about how women can help make this vision come true, she proposes an army.
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