As medical science evolves, breaking new grounds and challenging the conventional boundaries of health and aging, a fascinating field of research is emerging that could redefine the future of women’s health: the possibility of delaying or even preventing menopause in healthy women.
What is Menopause
- Menopause describes the point in life when the last menstrual cycle occurs, which happens around the age of 50 in women. Ovarian reserve depletes in the years, and decades, before menopause occurs.Many welcome the end to periods and worries about unwanted pregnancy, but menopause, and the perimenopause before it, is often accompanied by troubling symptoms such as hot flashes, cognitive problems, night sweats, vaginal dryness, anxiety, and a reduced sex drive.
- Now, researchers may have found a way to delay, and perhaps even prevent, menopause.A modeling study suggests that by removing, freezing, and then reimplanting ovarian tissue, the fertile years can be extended long beyond the normal age of menopause.
This groundbreaking research, centered on ovarian tissue freezing, is not merely an academic endeavor but a potential game-changer for women’s reproductive longevity and overall well-being.
Menopause, which for most women happens between the ages of 40 and 58, signals the end of the reproductive years. Although the end of monthly periods and worries about birth control is often welcome, many people will experience a less welcome range of physical and mental symptoms.
These symptoms, which may include hot flashes, night sweats, bone loss, vaginal dryness, anxiety, and a reduced sex drive, can start long before menopause and continue for several years afterward. So, could a treatment that delays, or even prevents, menopause be beneficial?
How Menopause can be delayed
Researchers at Yale School of Medicine believe that it would and may have found a way to do it. They suggest that by freezing ovarian tissue taken from a woman during her reproductive years and then reimplanting it at a later stage, they could delay, or even prevent menopause.
Traditionally viewed as an inevitable phase of a woman’s life, menopause is now the subject of intense debate and re-evaluation within the scientific community.
The discussion revolves around the potential to extend the child-bearing years and mitigate the various health risks and discomforts associated with the decline in estrogen levels. Research has shown you can delay menopause
At the heart of this revolutionary research is Dr. Kutluk Oktay, a distinguished ovarian biologist at Yale School of Medicine (YSM), who is pioneering the exploration into ovarian tissue freezing as a means to significantly delay or outright prevent menopause.
“For the first time in medical history, we have the ability to potentially delay or eliminate menopause,” Dr. Oktay asserts, underscoring the unprecedented nature of this advancement.
Ovarian transplant has been used to help restore fertility following cancer treatments that can damage the egg reserve in the ovaries. Surgeons remove ovarian cortex tissue before the cancer treatment, freeze (or cryopreserve) it, then implant it back into the person after cancer treatment is successfully completed.
Ovarian cortex is the outer part of the ovary, where most of the follicles — the structures that mature each month to release an egg at ovulation — are found. For freezing and transplant, the cortex can be from a donor or from the person undergoing the treatment.
Now, scientists led by Prof. Kutluk Oktay, M.D., Ph.D., have suggested that the technique could be used to preserve fertility and prevent troubling symptoms by delaying or even preventing menopause.
How effective is ovarian transplanting?
The model predicted that for most women ages 40 and under, ovarian tissue cryopreservation and transplant would significantly delay menopause.
The success of the transplant depended on four factors:
- Age at ovarian tissue harvest (21-40 years)
- Amount of ovarian tissue harvested
- Single vs. Multiple transplants of harvested tissues
- The proportion of follicles that survived post-transplant.
Tissue harvested after the age of 40 years did not delay menopause onset as there were too few viable follicles left in the tissue of the typical donor.
“The younger the person, the larger number of eggs she has, as well as the higher the quality of those eggs,” Prof. Oktay said. The amount of tissue harvested was key — too little and menopause would not be delayed, but if too much was taken, this might bring on an early menopause. However, the model accounted for this: “This model gives us the optimum amount of tissue to harvest for a person of a given age,” he added.
To illustrate their model, the researchers give the example of a 25-year-old who had 25% of her ovarian cortex tissue harvested, and then transplanted in one procedure. If 40% of the follicles survived, this might delay menopause by almost 12 years; if 80% survived, the delay would be around 15.5 years. Authors noted that currently, ovarian transplant procedures are associated with a 60% loss of follicles and that 80% survival could only be achieved if technology and techniques progressed in coming years.
The researchers used data from previous studies of ovarian reserve at different ages, and on how ovarian follicles behave in ovarian tissue. From this, they created a mathematical model that predicts how long ovarian transplant surgery might delay menopause in healthy women.
They incorporated several factors, including age and follicle survival, in their model to see how long different factors might delay the time of menopause.
This model predicts the potential duration of menopause delay in healthy women, factoring in variables such as the age at which the procedure is performed and the amount of ovarian tissue harvested.
This model accounts for the survival rates of primordial follicles post-transplantation, an aspect expected to see improvements with technological advancements.
Historically utilized to safeguard fertility in cancer patients, ovarian tissue cryopreservation involves the laparoscopic removal and subsequent freezing of ovarian tissue at extreme temperatures. Research offers a bright outlook, suggesting significant menopause delay for women under 40
This tissue can later be reimplanted, rejuvenating ovarian function. Expanding this technique’s application to healthy women opens up the prospect of prolonging their fertile years and potentially delaying the onset of menopause.
Dr. Hugh S. Taylor, Chair at YSM, highlights the procedure’s appeal, particularly for women looking to postpone pregnancy for various reasons.
Beyond extending reproductive years, delaying menopause could confer additional health benefits.
Studies indicate that a later onset of menopause is linked with longer lifespan and diminished risk of several conditions, including cardiovascular disease and osteoporosis.
However, the applicability of these benefits to women undergoing ovarian tissue cryopreservation is still under investigation.Apart from delaying symptoms, studies have shown that there may be other benefits to later menopause. Those who experience a later menopause have lower all-cause mortality, reduced risk of osteoporosis, and a reduced risk of cardiovascular disease. However, they do have an increased risk of breast, endometrial and ovarian cancers.
While the scientific community eagerly awaits the publication of outcomes for healthy women opting for this procedure, the existing research and mathematical modeling provide a promising glimpse into the future.
The implications of being able to alter the timeline of menopause are profound, heralding a new era in how this life stage is perceived and managed.
Nonetheless, this pioneering path is paved with the necessity for meticulous research to unravel the full spectrum of long-term benefits and risks associated with delaying menopause through ovarian tissue cryopreservation.
