Manipulating Menopause: Should You Rejuvenate Your Ovaries?
In July of 2016, a research team led by gynecologist Konstantinos Sfakianoudis at the Greek fertility clinic Genesis Athens shocked the menopausal world by declaring they had found a way to rejuvenate postmenopausal ovaries, enabling them to release fertile eggs. The study’s findings were presented at the European Society of Human Reproduction and Embryology annual meeting in Helsinki, Finland, and New Scientist first reported the study results. (The study has yet to be released in a peer reviewed medical or scientific journal.)
Sfakianoudis and his colleagues started with the blood treatment, PRP, or platelet-rich plasma that is made by centrifuging a sample of someone’s blood to isolate the molecules that trigger the growth of blood vessels and tissue, a treatment that is often used in sports injury recovery. But when PRP is injected into the ovaries, the researchers found, it can restart the periods of menopausal women. Sfakianoudis said, “It offers a window of hope that menopausal women will be able to get pregnant using their own genetic material.”
Sfakianoudis cited an example of a woman five years into menopause who had her periods start again. The research team was able to collect three eggs which were then fertilized by her husband’s sperm and were awaiting being implanted into the woman’s uterus. The team had given PRP to 30 women between the ages of 46 and 49, and they were able to isolate and fertilize eggs from “about two-thirds of the cases,” Sfakianoudis said.
The researchers admitted, though, that they weren’t sure how the technique worked. “Some research suggests a small number of stem cells continue making new eggs throughout a woman’s life,” New Scientist reported. So it is possible that the PRP triggers stem cells to generate tissue and produce hormones that induce ovulation.
Can scientists counteract the effects of menopause?
Besides being used to increase or restart fertility, researchers are looking at ways PRP can be used to counteract the effects of menopause—hot flashes and night sweats and the changes in skin, bones and the heart that happen as women age, by boosting the supply of youthful hormones and delaying menopause symptoms. Dr. Andrew Weil, M.D., integrative medicine doctor and founder of the Weil Foundation in Phoenix, Arizona, said, “If PRP really can reverse menopause and restore or prolong ovarian function, it might also benefit women who aren’t interested in pregnancy but face the risks of heart disease and osteoporosis that accelerate after menopause. The procedure could also potentially be used to help reduce hot flashes and other menopausal symptoms.”
But Sfakianoudis said that they need to conduct larger studies before they understand just how effective menopause treatment using PRP is. Critics have raised concerns about the procedure’s safety and efficacy, as well as the ethical implications of women on the upper age limits being pregnant, since pregnancy in older childbearing ages represents increase health risks for them and for the fetus.
More questions than answers?
I talked to Dr. Alisha H. Wilkes, DNP, CNM, ARNP, of Three Moons Midwifery near Seattle, Washington, about this study. Dr. Wilkes has worked with more than 500 women in her career as an advanced registered nurse and certified midwife.
When she read the New Scientist article, she said, “For me this article raises more questions than it answers. Without knowing how eggs and/or the endometrium are being stimulated there is no way to measure the potential physiological side effects women may encounter, let alone understand the quality of the eggs themselves. We know as eggs mature (women have them from the time they are fetuses themselves) their genetic material degrades; therefore, this type of fertility induction may increase the chances of miscarriage, genetically abnormal fetuses, etc. Enhancing, preserving and inducing belated fertility are all topics rife with ethical questions, as well. I tend to lean toward trusting the inherent and natural wisdom of bodies, but to address this topic in particular there is too much we still do not know.”
Trying to control women’s hormones at all of the stages of life is not new. For decades, women have been given the Pill to prevent conception, drugs and IVF to encourage conception and hormone replacement therapy or bio-identical hormones to lessen the symptoms of menopause.
Is it safe to postpone menopause?
Joanne from California (who asked that her last name not be used) commented that, after the complicated pregnancies and births of her two children in the early 1970s, she became depressed and had horrible menstrual cramps, accompanied by a heavy flow. Her doctor advised that she not have anymore children and put her on hormonal birth control, which she was on for the next 43 years.
Well into her 70s, she still had periods and had no signs of menopause. She reported that she “felt good” through those four decades and that she even enjoyed the feeling that she was “still cleansing monthly.” It wasn’t until after her complete hysterectomy a few years ago, when she was in her mid-70s, that she experienced her first hot flash and night sweat. “My female relatives kept telling me how dangerous it was for me to be on those hormones and not go through menopause,” she said. “But I felt great. My doctor monitored it, adjusted the hormone levels as necessary and it worked for me.” She said she wouldn’t have done it any other way.
But Joanne may be an exception. Some women can’t wait until they stop menstruating or until an unplanned pregnancy is no longer possible. Other women, who may have prolonged having children and still want to become pregnant or who hate the hot flashes and night sweats, may be grateful for the work being done at Genesis Athens. Only time and prolonged study will tell the effects, benefits and drawbacks of using PRP in the treatment of women’s health issues.
In the meantime, women serve themselves best by listening to their bodies, consulting their doctors, and weighing the risks and benefits of any type of manipulation of their cycles or of menopause before making any decisions. Health care and treatments should never be a one size fits all model, which is why it is important to know yourself, what works for you, and to listen and love your body in all of its stages.