Menopause

The Mayo Clinic Women's Health Research Center studies a variety of conditions that affect women's health during their reproductive years.

Early menopause

Mayo Clinic researchers discovered that women who experience menopause at younger ages — before ages 40 to 45 — have an increased risk of diseases such as dementia, parkinsonism, osteoporosis, heart disease, mood disorders and sexual dysfunction later in life, particularly if they do not take hormone therapy until the average age of menopause, around age 50. This discovery has allowed physicians to better treat women experiencing early menopause with hormones to reduce these risks.

Investigators are also examining how genetic changes in the genes that metabolize estrogen contribute to early menopause. Genetic screening of women with primary ovarian insufficiency may help to direct hormonal therapies to sustain ovarian function.

Surgical removal of the ovaries and primary ovarian insufficiency are two reasons women might experience menopause earlier than the normal age range of 45 to 55. While some women might have their ovaries removed prior to menopause — for example, to reduce the risk of ovarian or breast cancers due to a BRCA gene mutation — other women experience early menopause because their ovaries stop functioning due to genetic variations, chemotherapy or radiation or for unclear reasons.

Menopause and aging

Menopause is a time of significant hormonal change for women. Approximately 80 percent of women experience hot flashes and night sweats during this transition, which may last for nine years or more. Other symptoms related to the hormonal changes of menopause include problems with mood, memory, concentration, sleep and joint pains.

Physicians at Mayo Clinic have developed the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS) to improve understanding of how women experience menopause, what makes symptoms better or worse, and how health care providers can help women through this natural part of aging.

Research topics include the impact of caffeine on menopausal symptoms, whether women with recent histories of domestic abuse have more-bothersome menopausal symptoms, and whether women's knowledge and perceptions of menopause impact their menopausal symptoms. Other studies investigate the best formulation of menopausal hormone treatments based on how women's bodies metabolized estrogen through analysis of their genotypes.

Cognitive decline and Alzheimer's disease

The Mayo Clinic Women's Health Research Center focuses on biological factors contributing to sex differences to help improve the care of both men and women with Alzheimer's disease. For example, researchers in the center discovered that the APOE-e4 gene may be more strongly associated with Alzheimer's disease in women and may be influenced by estrogen. Research is now focused on how estrogen affects the development of amyloid that builds up in the brain with the advancement of Alzheimer's disease.

The number of people with Alzheimer's disease is increasing as the population ages, and women are disproportionally affected. Almost 2 out of 3 people with Alzheimer's disease in the U.S. are women. After age 60, women are twice as likely to develop Alzheimer's disease as they are to develop breast cancer as they age. By the age of 65, women have a 1 in 6 chance of developing Alzheimer's disease, compared to 1 in 11 men.

Women and caregiving

Researchers in the Mayo Clinic Women's Health Research Center have developed and are testing a multicomponent behavior intervention developed to reduce burden, depression and anxiety in caregivers and to improve their coping. The center's initial study found that the behavioral interventions under investigation improve neurobehavioral outcomes more so for women than for men. Factors underlying this observation warrant additional study in order to optimize outcomes for all.

It is estimated that 66 percent of caregivers are women. Women live longer than men do and are therefore at heightened risk of health issues related to disease burden and caregiver stress, underscoring the importance of early intervention.