Sean Collins

Are we at the end of menopause, Anna?

Anna North

The end of menopause is a ways off, but we could be close to being able to delay menopause. There's a couple of treatments that may be able to push back menopause significantly, and one researcher I spoke to for my piece has talked about eliminating it. 

One researcher I spoke with, Dr. Zev Williams, tested a drug called rapamycin in mice, and it extended ovarian function, so they were fertile later on in their little mouse life spans. 

Dr. Williams wondered if this would work in humans also, and he's now in the midst of a clinical trial. Women between 35 and 45 have taken the drug, and they're currently being monitored to see what the effects will be. It’s still early, so they're not sure what they're going to find yet, but they're excited. 

The second treatment has already been tested in cancer patients. If someone goes through cancer treatment, they may lose ovarian function and go through an early menopause. 

In response to this, a researcher named Kutluk Oktay worked on this technique called ovarian tissue cryopreservation, where you remove portions of the ovary, freeze them, and implant them again in cancer survivors at a later date. Now, he wants to see if it would work in healthy people. Based on a mathematical model he created, he's hopeful that it could.

Sean Collins

What are some of the arguments for wanting to delay menopause?

Anna North

When I started hearing about the idea of delaying menopause, I was inherently skeptical; I felt like, Is this just anti-aging — are we saying we don't like older women?

Then I started to wonder, Is this a way of saying we want women to be fertile forever? I don't know if I want to be fertile forever. 

After talking with the researchers, I have a more nuanced view. Most scientific conversations around delaying menopause are actually about the idea that ovaries have this really active role in people's health that we're only just starting to understand, and we want to maximize the potential health benefits ovaries give people.

There are all these conditions that become more common after menopause: cardiovascular disease, high blood pressure, high cholesterol, insulin resistance, and osteoporosis, among others. 

Now, some of these are just conditions that become more common with aging, but some scientists think that the estrogen produced by ovaries protects women from these conditions. The idea is, when we lose that estrogen, then we become more susceptible. The researchers who are working on delaying menopause are thinking, How can we extend the health benefits of the ovary for the longest time possible? 

Some of the first patients that this research may be useful for are people who are going through premature menopause. Research shows Black and Latina women on average go through menopause earlier than white and some Asian American women, and in some cases, women of color have a longer duration of bothersome menopause symptoms. 

Finally, it’s possible that this research might help people have kids when they’re older, but the researchers told me that’s not the primary reason why they want to do this work.

Sean Collins

Are there arguments against trying to advance this research?

Anna North

I'm not sure that anyone is saying we shouldn't be looking into this at all. But I did find some skepticism, and I still have some questions. 

There are folks who say we really don't know how much aging-related conditions are related to menopause, and how much is just a part of getting older. There are questions about whether pushing back menopause would actually make women healthier.

When it comes to cryopreservation, the operation is done laparoscopically, so it's minimally invasive, but it’s still surgery — it's not trivial.

There are also social considerations. A lot of people find a benefit and freedom in menopause. I talked to some anti-ageism advocates and other folks who work on menopause, and they said people find menopause to be a time when they can recalibrate their lives and focus more on themselves. 

Also, practically speaking, a lot of people don't want to be fertile forever. A lot of people don't want to have a period forever. It's annoying. And for people who can get pregnant, preventing pregnancy is a big part of your life and something you have to worry about all the time; to not worry about that is a big deal, and a big relief for a lot of people. 

It's funny, I posted the story on Bluesky, and a lot of the responses I got were like, Could I have menopause earlier, please? People just wanted to not have to worry about that stuff anymore. 

Sean Collins

Overall, is trying to delay menopause something we should be doing? 

Anna North

Nobody in the scientific community that I talked to was like, Yes, less reproductive health research. 

For me, it’s more of a question of how we ensure we don't demonize menopause. I don't want us as a society to think people with ovaries shouldn't get older, or that they should be fertile forever. As someone that's getting older myself, I don't want this to be a time of life that people are encouraged to fear, when we're already so often encouraged to fear aging. 

So I think that the question is more, How do we think about this research in the larger context of people's lives — and what is this for?

If this is for helping patients stave off negative health outcomes, that’s positive. If it’s making us more against getting older and more against having transition times in our lives, then I get worried about that.