Could delaying menopause help us live longer?

In the race to crack the longevity code, researchers are attempting to prolong ovarian function to keep menopause-related diseases at bay. But what are the risks involved and are they being adequately considered? Sabrina Rogers-Anderson investigates. 

By Sabrina Rogers-Anderson

With the medical world finally starting to give menopause and its oft-distressing symptoms the attention they deserve, a growing number of women are receiving the support and treatment they need to navigate this challenging life transition.

But despite these advances, we still have tunnel vision when it comes to menopause. We tend to view it simply as the end of a woman’s reproductive era, characterised by missed periods, hot flashes and mood swings.

As a growing field of research – particularly Columbia Fertility’s VIBRANT study –  is demonstrating, this is only a small piece of the puzzle.

The ovaries also play a critical role within the endocrine system, a collection of glands and tissues that release hormones to keep our bodily functions running smoothly. 

When the ovaries stop sending out their chemical signals to other organs and systems at menopause, health issues can start to rear their ugly heads.

“There’s a whole raft of physiological and mental changes that happen at menopause that can lead to chronic disease,” says Dr Kelly Teagle, women’s health GP and founder of Telehealth menopause clinic WellFemme.

“The risk of cardiovascular disease and dementia rises, and bone density drops, which can lead to osteoporosis. And there are several other issues that occur as a result of hormonal changes at menopause.”

Menopausal hormone therapy (MHT) is the first-line treatment to relieve menopausal symptoms and it protects women against these health risks in the process. 

“Women who are on MHT have better bone density, a lower risk of diabetes and cardiovascular disease, and they die of cardiovascular disease at lower rates than those who aren't on MHT,” notes Dr Kelly.

“Many women start taking MHT because they have symptoms and we then see this prevention of chronic disease as a secondary effect. Even if they stop taking MHT, that benefit is carried with them for the rest of their life, which is what we call a legacy effect.”

But despite the benefits of MHT, some women aren’t suitable candidates – such as those with hormone receptor positive breast cancers – and others don’t want to take it. 

New research attempts to delay menopause to increase longevity

University of Queensland researchers found that women who go through premature menopause (before the age of 40) – whether due to lifestyle factors or surgical ovary removal – are at higher risk of developing a range of chronic conditions, including diabetes, heart disease, stroke, osteoporosis and breast cancer.

Conversely, participants in the landmark Women’s Health Initiative study who went through late menopause – after age 55 – lived longer than those who hit menopause earlier.

Faced with the undeniable fact that later menopause is associated with better health outcomes and increased longevity, scientists around the world have been searching for ways to delay the process.

In the US in March 2024, then-President Joe Biden launched a women’s health initiative that aimed to spearhead research into maintaining ovarian health through midlife to ward off chronic diseases. 

But what does delaying menopause entail exactly?

Columbia University researchers are currently investigating whether rapamycin – a drug originally developed to prevent organ rejection in transplant patients – could slow ovarian ageing by reducing the number of eggs that die off each cycle.

Rapamycin has already been shown to delay the ovarian ageing process in mice and separate studies have found it may have other anti-ageing properties.

The researchers hope to develop an inexpensive weekly pill that could keep menopause and its associated chronic illnesses at bay. 

New York-based biotech company Oviva Therapeutics is in the process of developing a synthetic form of human anti-Müllerian hormone (AMH), which plays a critical role in slowing the depletion of ovarian reserves. 

By reducing the number of eggs women lose per cycle, the treatment could extend the lifespan of their ovaries and potentially increase their longevity.

The catch? Oviva is in the early stages of testing, so it could be a while before the product is available to the public. 

Weighing up the potential risks of hindering menopause

As with any new drug, long-term safety data will be lacking if and when these treatments hit the market. 

“There’s only enough observation time within studies to convince the TGA or FDA that no bad side effects have occurred,” Dr Kelly explains. “But nobody can tell you what the effects will be in 10, 20 or 30 years until patients have been using it for that length of time. So, you start using it in clinical practice and see what happens."

And while delaying menopause may have a host of health benefits and increase lifespan, research shows that later menopause increases the risk of fatal ovarian or uterine cancer.

“There's a link between hormones and certain types of cancer, so we don't know what the secondary effects of having women's ovaries functioning for longer will be,” says Dr Kelly.

She also has concerns about the societal implications of pushing the longevity envelope.

“Current research could result in people routinely living to 150 within a couple of generations,” she explains. “The problem is that science is outstripping our social and logistical capacities to cope with this reality.

Look at social media – the science was well in advance of any infrastructure or legal framework and nobody thought out the consequences or how to manage them.”

If we end up with double the number of people over the age of 80, how will we feed and house them? Dr Kelly wonders. What if we end up with a lot of people who are chronically impaired and dependent for decades?

What if humans were just not psychologically designed to live that long, what's that going to do to our minds? There are a lot of factors to consider, she says.

“I'm all for interventions that improve our health, independence, function and quality of life at an older age. My women's wellness program, Next Phase, is designed exactly for that. We want to prevent chronic disease and keep people well, functional, independent and strong.

“But extending life just because we can without thinking about what that life is going to look like can be dangerous.”

Dr Kelly is more interested in considering the quality in the years people live, rather than the quantity: “If it turns out that women's exposure to their natural reproductive hormones keeps them strong, functional and independent for longer, that's great. But simply wanting to add decades to people's lives might not be the answer."

What you can do now to increase your longevity

Don’t feel like waiting around for a pill or perhaps the menopause ship has already sailed? There are plenty of lifestyle changes you can make to add years to your life. 

^{Feature image: iStock/SolStock}

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