In the research paper titled “Brain-derived neurotrophic factor and related mechanism that mediate and influence progesterone-induced neuroprotection,” Dr. Singh and his colleagues investigated the gonadal hormone progesterone and its roles in the human body. Dr. Singh discussed how estrogen and progesterone levels drop when women go through menopause. In fact, women are in an estrogen-deprived state for a third of their lives. As a result, women experience hot flashes, mood swings, poor sleep, and consequences to the brain that may make cognitive functioning and learning more challenging. The article titled “The new science of menopause: these emerging therapies could change women’s health” posted on Nature News discusses the implications of using hormone replacement therapy, and new research for prolonging ovarian lifespan. The article explains that menopauses bring higher risks for many health conditions such as cardiovascular disease, osteoporosis, diabetes, and memory loss. Oral contraceptives are one way physicians attempt to ease the symptoms many women face during menopause. However, Naomi Busch, a physician and certified practitioner through The Menopause Society, which is a non-profit organization, explains that oral contraceptives are not as effective and can also increase the risk of developing blood clots. Fezolinetant and elinzanetant, which are non-hormonal drugs, are used to treat hot flashes, yet they also have side effects. The article mentions other options that people take to deal with the menopause symptoms such as antidepressants, acupuncture cognitive behavioral therapy (CBT), and lifestyle changes. However, the issue still remains since these methods aren’t enough to provide effective treatment.
Hormone replacement therapy is one of the more effective treatments for menopause symptoms, yet it is often overlooked due to a widespread fear of potential side effects, often fueled by misinformation. Hormone replacement therapy works to restore the reduced hormones such as oestrogen and progesterone. This can delay or prevent osteoporosis, even providing other health benefits. The fear surrounding hormone replacement therapy started when a study called the “Women’s Health Initiative (WHI)” claimed those taking oestrogen and progestin had a slightly higher risk of heart attack, stroke, and breast cancer. After further research, it was revealed that the study had significant limitations and mistakes in interpreting this data. Contrarily, the data showed a lower risk of heart disease and death from hormone replacement therapy. It also showed that oestrogen-only therapy reduced breast cancer rates. Another review of the paper was done, and many authors from the original paper worked on this. They emphasized that the formulation of the hormone, route of delivery, and the dosage used in the WHI trails are not the same that is used today. In the trials, the route of administration was the oral route, which raised concerns about blood clots. Now, we have transdermal patches, which removes this concern. One other issue the researchers considered was the timing of when this hormone replacement therapy was started. In the study, those who participated were around a decade into their postmenopausal years. Hormone replacement therapy also has other benefits aside from managing symptoms of menopause. It has been shown to prevent osteoporosis in all ages and even have implications for benefiting brain health, if timed correctly. Susan Davis, a director of the Women’s Health Research Program at Monash University does, however, point out that the exact risks and benefits still remain unclear. Despite this, JoAnn Manson, a women’s health researcher at Harvard Medical School, says women should highly consider hormone therapy before age 60, within the 10 years of menopause. Wearable sensors are now also available which could help identify when the best time is to start hormone therapy is. Future advancement might include the sensor itself dispensing hormones when needed.
Another research wants to develop a drug that would prolong the ovarian lifespan. Zev Williams, a reproductive endocrinologist at Columbia University, and his colleagues looked at the use of rapamycin, which is an orally administered drug that helps prevent the body from rejecting an organ transplant. Previous research in mice has shown that it could extend the functioning of ovaries, potentially delaying menopause. Other approaches include saving ovarian tissue from when women are young and freezing it, then replanting to slow down the aging of the ovaries to delay menopause. However, Stephanie Faubion who is the director of Mayo Clinc’s Center for Women’s Health, says removing ovarian tissue could potentially have a opposite effect and increase the risk of early menopause.
Nevertheless, Busch still suggests hormone replacement therapy if there are no contradictions for its use. Not every type of medication or treatment is going to work the same for everyone. While hormone replacement therapy is currently the best option, the field is growing, and potentially even better options with new research is underway.
References:
Peeples, L. (2025, January 22). The new science of menopause: These emerging therapies could change women’s health. Nature News. https://www.nature.com/articles/d41586-025-00069-4
Singh, M., Krishnamoorthy, V. R., Kim, S., Khurana, S., & LaPorte, H. M. (2024, January 15). Brain-derived neuerotrophic factor and related mechanisms that mediate and influence progesterone-induced neuroprotection. Frontiers. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1286066/full
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