The Effects of Hormone Therapy on Menopause: A Review of the Research Funding Aging Programs in the United States and Europe
Nature asked some of the large health- research funding agencies in the US and Europe about their plans to study the effects of hormones on the body. According to a paper in Nature Aging, a majority of studies don’t consider menopause in the field of aging. Nature Aging 3, 1500–1508; 2023). There was a category for menopause research established by the National Health Service. The sums involved are not huge, but this isn’t a complete surprise. We have reported before that conditions that affect women receive less funding than those that affect men. There will be US$5 million allocated to menopause studies in the next two years, and there is a projection to increase to $58 million this year.
The data from the subsets of participants in the WHI and other trials revealed that there were inconsistencies in the findings, such as a lowered risk of heart disease and death associated with hormone therapy, and an increase in breast cancer for those taking oestrogen only therapy. Scientists have been trying to set the record straight since.
Long-term benefits that can outweigh any risks are possible, and include managing menopause symptoms. Osteoporosis has been preventable with the use of menopause hormone therapy. The benefit of oestrogen for fractured bones was missed in the story. She is looking at whether testosterone could protect the bones after menopause.
The equation gets more complicated when it comes to heart disease. If the therapy is started early, evidence suggests that it might prevent vascular disease. But, in people with vascular disease, researchers say, the therapy might worsen the condition. There are also emerging hints that well-timed therapy can benefit brain health.
The exact benefits and dangers of the therapy are still unknown, says Davis. You could hear any story that you want to hear, depending on how you slice and dice the data. Her concern is that researchers continue to trawl big data sets without understanding the nuances and limitations of the data.
When the ovaries fail, says Renee Wegrzyn, director of the Advanced Research Projects Agency for Health (ARPA-H), a government agency tasked with steering the White House Initiative on women’s health, “there are a lot of chronic health conditions associated with that”. Scientists have different ideas about how long the ovaries should be working.
Still, some specialists point out, replacing hormones might not be enough. The ovaries are responsible for a lot more than making eggs and oestrogen. Zev Williams says that small organs sending chemical signals throughout the body drive many other factors with health benefits.
Tracking hormone levels in real time could help identify the optimal window for starting hormone therapy. Some physicians don’t want to use the therapy during perimenopause because of the potential for high combined hormone levels during natural fluctuations. One day, these devices might even dispense hormones on an as-needed basis.
Nature’s Biggest Funders: Exploring the Science of Menopause in the U.S. Between 2022 and 2024
Nature asked the world’s largest funders about their research on life stages experienced by half of humanity. Here is what they had to say to us.
The number of health-care professionals looking into becoming certified to treat menopause is increasing. In the United States between 2022 and 2024, there was a five-fold increase in the number of people applying for the menopause society’s certification exam.
Many of the initiatives are not well known. On the funding side, perhaps one of the more surprising things is that, so far, few funders seem to be following in the NIH’s footsteps.
Establishing a separate research category is a sign that funders want to look at menopause as a priority. It allows researchers to know how much money is available, and how to apply, so they can monitor what has been spent in the past.
The US Advanced Research Projects Agency for Health has two menopause projects worth $13.50 million, with one purpose to extend ovarian function and the other to develop ovarian implants to prevent diseases associated with menopause.