Two doctors sound off on this fiery debate.
Saying that menopause is complicated may be the understatement of the year. We’ve previously written about all things “second puberty” — from the upsides (yes, they exist) to the troubling downsides (bone health, anyone?). But what if this mess of emotions and physical symptoms could easily be sidelined for a while? Would you jump at the chance to delay menopause?
That’s right — researchers and scientists are busy developing technologies that would extend fertility and put off menopause. And with menopause goes its bevy of irritating symptoms, confusing treatment options, and anxiety-inducing health risks. Sounds great, right?
Not so fast: Some doctors disagree with the idea of delaying the change. To get all the relevant details, we spoke to two physicians with opposing opinions on this hot topic. (Plus, we’re clearing up a common misconception about what hormone replacement therapy actually does.)
Does HRT delay menopause?
Do you think that hormone-replacement therapy (HRT) is “delaying” your menopause? Think again: While chemically assisted relief from the change’s many side effects might feel like a delay, all those hormone pills, patches, and creams are just soothing menopause symptoms, not changing what’s happening inside your reproductive system.
Truly delaying menopause would mean stopping the ovary from failing, and therefore extending fertility. And at the end of the day, an estrogen patch isn’t designed to stop the change completely. Instead, HRT alleviates symptoms by boosting your depleted hormone levels — which is especially helpful when it comes to bodily factors like weight and sexual function. We’re grateful for everything that HRT can do, but those who partake in it are still in menopause while receiving the therapy.
Now that we’ve cleared that up, here are all the nitty-gritty details on whether it’s possible — or advisable — to delay menopause altogether.
Can you postpone menopause naturally?
If you’ve feverishly Googled “how to delay menopause,” you’ve likely run into articles that claim you can eat your way toward hormonal nirvana. But is it really possible to load up your dinner plate with magically menopause-postponing veggies?
According to Stephanie S. Faubion, M.D., M.B.A. — director of the Mayo Clinic’s Center for Women’s Health and author of The New Rules of Menopause — it’s not currently possible to naturally delay menopause: “We can’t take the natural ovary and make it not fail. We have not figured out how to do that.” Dr. Faubion does say, however, that healthy choices can shape and change your bodily trajectory.
“The only thing in our control is our general health,” Dr. Faubion points out. “You can look back at different populations in history, and when they’ve had famine, war, or very poor nutrition for another reason, menopause age gets earlier. And in underdeveloped areas of the world, menopause age is typically earlier than it is in the United States. So good health, good nutrition, and good habits may help to delay menopause a little bit.” (A 2003 study revealed that women who’d endured starvation during the 1944-1945 Dutch famine went into menopause as much as 1.83 years earlier than women who hadn’t, depending on the age at which they’d experienced hunger. Another study examined a group of women born during the Great Chinese Famine and found that the participants’ exposure to prenatal famine resulted in a higher likelihood of early-onset menopause. So nutritional deficiencies before birth may encourage “second puberty” at a younger age.)
Still, Dr. Faubion adds that the perfect meal plan can only take you so far: “The bottom line is that you’re not going to fool mother nature.”
Taz Bhatia, M.D., author of The Hormone Shift: Balance Your Body Through Midlife and Menopause (who goes by Dr. Taz) sees a lot of promise in the potential health and quality-of-life benefits of delaying menopause. Like Dr. Faubion, she says that when “patients are incredibly nutritionally depleted, highly stressed, or underweight, those populations tend to go into menopause much earlier.”
But unlike Dr. Faubion, Dr. Taz argues that the evidence of nutrition’s potential impact on the onset of menopause should be the beginning of the conversation, rather than the end.
“Menopause has been defined as a decline in hormone levels, a part of the natural aging process. But we’re turning the entire concept of aging upside down on its head and realizing how much we have control over some of that process,” she says. “There’s a lifestyle component and a dietary component, not just a genetic component. For example, eating a lot of antioxidants will really plump up the cells and provide a lot of oxygen to the body.” (A 2018 study found a link between the regular consumption of oily fish and fresh legumes and a delayed age of menopause, while eating more “refined pasta and rice as well as savory snacks,” was associated with an earlier onset.)
Can doctors postpone menopause using new technologies or procedures?
When it comes to medically delaying menopause, Dr. Taz says that emerging technology is encouraging, but Dr. Faubion adds that delaying the change using this tech is currently impossible.
“There’s been some back and forth about even something like birth control pills maybe playing a role in delaying menopause,” Dr. Taz says. She adds that a procedure called ovarian tissue cryopreservation and transplantation seems promising: “Apparently, if you freeze a small piece of the ovary — younger women are doing this and then saving [the piece of the ovary] for later — and take that tissue and re-implant it decades later, then it starts bringing hormone levels back up to where they used to be. That’s a modality that I think is slowly gaining more traction.”
But Dr. Faubion states that ovarian tissue cryopreservation and transplantation will only benefit those who are undergoing a planned menopause in certain cases, like during cancer treatment. “For women who are experiencing menopause prematurely — due to, say, radiation or chemotherapy — we can maybe preserve the ovaries that exist and reimplant them later in a different place, or take frozen tissue and reimplant it. There are some techniques that we use to help those women who are going through a planned menopause.” Still, Dr. Faubion says that these technologies won’t benefit you if you’re reaching natural menopause: “We can’t take a healthy ovary and make it not age… It’s not yet possible to delay natural menopause using medication or technology,” she explains.
Why should we postpone menopause?
Ultimately, these experts disagree over whether we should attempt to stave off the change. For Dr. Taz, it’s a no-brainer: “When you’re delaying menopause, the benefits are protecting and preserving bone health, heart health, mood, energy, sleep, libido, hair, skin, and weight.” (Still, Dr. Taz says that the increased risk of hormone-related disease is a sticking point: “If your body is holding onto a hormone or accumulating it, that’s when we worry about the risk of breast cancer or any hormone-based cancers or hormone-triggered autoimmune diseases.”)
Dr. Faubion, on the other hand, encourages us to look at why we really want to delay menopause: “We know that women tend to undergo a more rapid aging after they go through menopause. If they go through menopause prematurely before the age of 40, we see [aging] happening. So the theory would be that if we can delay menopause, that would delay aging.”
But Dr. Faubion points out that we need to untangle our perception of menopause from the overall effects of aging. She points out that symptoms like weight gain or hair loss are enmeshed into our experience of menopause, but that these distressing symptoms may simply be due to age.
“What would actually get better if we make the ovary keep working?” she asks. “People are looking at [delaying menopause] like it could be a fountain of youth, but I don’t think we have enough evidence to say that. Now, could it help with certain disease processes? Maybe — again, we don’t know. The research isn’t robust enough to say that we’re close to being able to achieve that. Even if we do achieve it, will it give us the outcomes that we’re looking for? We don’t know.”
Dr. Taz and Dr. Faubion ultimately agree, however, that we each have power over our own lifestyles. The small daily health decisions we make add up — and it might be most realistic to start with your own health rather than pursuing medication or a procedure.
“Being healthy is the best thing that you can do,” Dr. Faubion argues. “Not that [being healthy] will appreciably extend your ovarian lifespan. It probably won’t. But it will help you have a longer health span. You’ll be healthier for a longer period of time if you have good lifestyle habits. People tend to look for the easy fix. But developing good health habits is probably the best option that’s in our control.”
