#65: ⏸️ Can We Press Pause on Menopause?
Understanding how and why ovaries age & what we can do to delay it
Happy New Year!
I’m back from a restful break, where I celebrated my first Friendsmas, had a cozy New Year’s Eve and I turned 36!
I love being an *almost* New Year’s Baby. It’s great for many reasons, one is that the end of the calendar year and the end of a year of life happening synchronously gives an extra special meaning to new beginnings and fresh starts. The second reason is that everyone is down to party 🙂 and often forget it’s not quite New Years Eve…yet.
As I turn 36, I took some time to reflect, and here are a few lessons learned from my 35th year:
Ignore anything and anyone that doesn't align to the life you are building. Double down on anything and anyone that does. (Credit to Abi Lajti for this gem)
Sometimes a hard reset is exactly what you need.
Ask for what you want, clearly and directly. More often than not, you get exactly what you ask, or don’t ask, for.
Hard work only moves you in life if you’re around people who appreciate and see the value of your work. Don’t work hard for people who don’t understand the value of what you bring to the table.
Never be afraid to walk away from a bad deal, even if it’s the only one on the table. Another one is always waiting.
Knowing what you don’t want opens the door to knowing what you do want.
The greatest risk comes from taking no risk at all.
🗣️ Looking for the read-aloud version of Nina’s Notes?
Find it here:
💬 In this note:
⏸️ Can We Press Pause On Menopause?
📚 The Running Grave
⚡️ A Simple Smartphone Guidebook
⏸️ Can We Press Pause on Menopause?
Menopause will affect every woman in the world and has a huge impact on women’s health and longevity.
Despite being a phenomenon that affects half of the world’s population, it is rarely discussed.
Menopause is caused by the aging of the ovaries, and the onset of menopause signals the end of a woman’s reproductive years.
Like all parts of our bodies, ovaries age. But what’s most interesting and puzzling is that ovaries are the organ in the female body that ages the earliest. They age at twice the speed of other body tissue.
Ovaries are responsible for the production of eggs for fertilization and the hormones estrogen and progesterone.
Estrogen levels decline with age. Eggs produced in the ovaries also naturally decline in quantity and quality, eventually leading to infertility and menopause at an average age of 48.
How Does Menopause Affect Health and Longevity?
Life expectancy of women has been increasing over the last 30 years, and continues to do so. However despite this increase in lifespan, the onset of menopause has only been delayed by 4 years.
This means that a woman may spend more years post-menopausal than pre-menopausal, and with that shift comes all of the major consequences of menopause and associated health decline.
While women live longer than men globally, this has not been accompanied by an equivalent increase in female healthspan. Women will spend on average 34% of their life in poor health compared to men who will spend only 26% of their life in poor health.
Ovarian health and its direct link to estrogen levels can influence the health of all phases of a woman’s life and could be a main determinant of female lifespan.
Being the earliest aging organ in the female body, ovarian age is considered to be the “pacemaker” of the female body’s aging. The decline of ovarian function drives the aging of multiple other organs in the body.
Increasing ovarian longevity could result in many health and socioeconomic benefits for women. Most obviously, delaying ovarian aging would alleviate the societal and reproductive pressure to have children before 35.
Furthermore, delaying menopause would lessen the years women spend in poor health, decreasing the risk of many age-related diseases such as cardiovascular disease, frailty and neurodegenerative diseases.
Possible Interventions to Delay Ovarian Aging
Many of the possible interventions which target the nine hallmarks of aging could be used to intervene in ovarian aging.
Oxidative stress caused by free radicals is thought to be a driver of ovarian aging, which could be reduced through antioxidant supplements such as curcumin, co-enzyme 10 and the hormone melatonin.
Melatonin is a natural hormone produced by the pineal gland in your brain which helps to control the sleep cycle.
It has been shown that melatonin levels decline with age. Some view melatonin as the “fountain of youth” and promote melatonin as an anti-aging hormone and supplement for menopause reversal (Bowles, 2017).
A study published in 2021 demonstrated that melatonin delays ovarian aging by inhibiting follicle activation, growth and degeneration of ovarian follicles and found that high-doses of melatonin have no obvious adverse effects.
More research is needed to fully explain the potential benefits of melatonin on ovarian aging, but the ease of taking melatonin, the lack of serious side-effects and potential benefits on the ovaries all indicate the promise of this natural hormone and antioxidant.
NMN (Nicotinamide Mononucleotide)
NMN is a compound that is involved in the production of NAD+ (nicotinamide adenine dinucleotide) in the body. NAD+ is a coenzyme that plays a crucial role in various cellular processes, including energy metabolism, DNA repair and cellular repair processes.
As we age, NAD+ levels decline and NAD+ replenishment extends healthspan, avoids metabolic syndrome, and reduces blood pressure in mouse studies.
Raising NAD+ levels has been shown to improve various heart problems like blocked arteries, heart muscle damage from lack of blood flow, diabetes-related heart issues, irregular heart rhythms, enlarged heart muscles, and weakened heart conditions.
A well-studied group of enzymes called Sirtuins require NAD+ to catalyze their enzymatic activity. Sirtuins are involved in a variety of biological processes, most importantly the transcription of genes, programmed cell death and aging.
Benefits of raising NAD+ levels include reversing neuronal degradation and improving neural plasticity. It is possible to boost NAD+ levels through diet and exercise, and supplementing with NAD+ precursors to reverse signs of aging.
NAD+ levels were also found to be an important factor in female fertility, contributing to the success of in vitro fertilization (IVF).
Additionally, SIRT1, a NAD+ dependent enzyme, is critical to ovarian function and fertility. Without SIRT1 laboratory mice were sterile.
Scientists have demonstrated that NAD+ supplementation can be used as an effective and non-invasive strategy to restore and maintain female fertility during aging.
Therefore, it is possible that supplementation with NAD+ boosters such as NR (Nicotinamide riboside), NMN and nicotinamide could be a potential way to delay menopause.
Caloric Restriction and Ways to Mimic It
Caloric Restriction (CR) has been studied for decades in a variety of species, mostly mice, and extends lifespan by altering the rate of biological aging.
Studies of CR in mice indicated that CR increased ovarian reserve, improved oocyte quality and prolonged the reproductive life span in mammals.
Caloric restriction can be hard to mimic in everyday life, and studies have shown both positive and negative impacts on female reproduction, and it is important to remember that there are differences between the findings in rodents and humans.
Caloric restriction mimetics, such as resveratrol, rapamycin and metformin, act on similar pathways in the body and could be used as an alternative.
Resveratrol is a natural compound found in 70 plant species, most notably in grapes, berries, and seeds. It acts similarly to an antioxidant, preventing the cells in the body from the damage of oxidation.
Rapamycin is a drug used to prevent rejection of transplanted organs, and many studies have shown it increases lifespans of male and female mice. A recent study showed that short-term rapamycin treatment in young and middle-aged female mice increased ovarian lifespan.
Metformin has been used to control type-2 diabetes for decades. It has been shown in animal experiments to slow aging, and because of its proven safety over decades and low cost, it is a likely first candidate for gerontological interventions.
More research is needed on metformin and female reproductive longevity, but metformin has been shown to safely and effectively improve ovulation rates in women with polycystic ovarian syndrome (PCOS) and has been shown to be safe during the first trimester of pregnancy.
Resveratrol and Metformin are thought to delay the ovarian aging process by inducing the expression of SIRT1 and reducing oxidative damage.
More experimental ideas to delay ovarian aging include platelet-rich plasma (PRP) blood transfers, stem cell therapies and gene therapies. However more research is needed to understand the benefits and safety of these therapies.
To start, leading a healthy lifestyle with a balanced diet, regular exercise and a good sleep routine, potentially supported by supplements such as resveratrol and NMN could possibly delay menopause.
📚 Book of the Week
The Running Grave by Robert Galbraith
Author J.K Rowling brings us her 7th novel in the Cormoran Strike series written under her pen name, Robert Galbraith.
Hired by a worried father to investigate a cult-like church organization, Cormoran Strike and his partner, Robin Ellacott, infiltrate the group to uncover the truth behind the Universal Humanitarian Church (UHC).
I usually really like the Cormoran Strike Novels but this one seemed to drag on forever.
It’s a really long book, and the fast action happened in the last 10% of the book.
When Robin went undercover to infiltrate the UHC, I felt deeply troubled for her. Despite not really liking the book, I had a hard time putting it down because I wanted to read Robin out of so many horrible situations.
As usual, Cormoran has several clients he balances at the same time, which results in a few side plotlines running in tandem with the main plot of exposing the UHC. I had difficulty keeping the other side-plotlines straight and did not care for them.
⚡️ Check This Out
Our parents taught us things over and over when we were kids, and now it appears it’s our turn to return the favor….with anything and everything tech related.
If you feel you’ve not gotten your parents to a place of tech independence, it might not hurt to share this simple smartphone guidebook.
They can reference it the next time they have an issue, before calling you.
…or worse, before waiting until the next time you visit home to fix the issue.
Edited by Wright Time Publishing