Project Highlights

The Women's Health Research Center funds multidisciplinary projects and studies across Mayo Clinic to advance research focused on the female body through all stages of life. Projects focus on illnesses, conditions and physiological responses that occur only in women, manifest differently in women compared with men, or are more prevalent in women compared with men.

Previous projects supported by Mayo Clinic Women's Health Research Center, or projects in collaboration with Mayo Clinic Women's Health, Specialized Center of Research Excellence (SCORE) on Sex Differences and Center for Individualized Medicine include these topics:

  • Hormones in venous thromboembolism-related pregnancy.
  • Neurovascular control and blood pressure after menopause.
  • Sex differences in asthma.
  • Differences in how older men and women respond to flu shots.

2022 Pilot Grant awardees:

Development of an artificial intelligence-based tool for noninvasive detection of coronary microvascular dysfunction in women

Heart disease is the leading cause of death among women. Heart disease is responsible for 1 in 3 deaths annually, with ischemic heart disease being the most common form in the U.S. Among women with symptoms of ischemic heart disease, more than half demonstrate nonobstructive coronary artery disease (NOCAD) on invasive angiography. Current clinical practice often requires the use of multimodality cardiac imaging in addition to invasive coronary angiography with provocative testing for a definitive diagnosis in patients with symptomatic NOCAD. As such, there is an urgent need for a streamlined, noninvasive and less-expensive testing option for diagnosing underlying NOCAD etiology, particularly microvascular dysfunction. In addition, available medical therapies for microvascular dysfunction are relatively safe, inexpensive and readily available.

The goal of this project is to develop a clinical decision support tool based on artificial intelligence models for detection and management of symptomatic NOCAD. Such a tool could allow patients to avoid excessive testing with its associated risk of procedure-related complications and consequently improve patient care and satisfaction.

Sex differences in immuno-inflammation with sleep apnea

  • Joshua (Josh) M. Bock, Ph.D.
  • Funded by Mayo Clinic Women's Health Research Center in collaboration with Specialized Center of Research Excellence (SCORE) on Sex Differences
  • (6/2022-5/2023)

Chronic sleep disruption, also known as chronic sleep insufficiency, increases the risk of developing cardiometabolic diseases to a greater extent in women relative to men. Similar observations can be made with sleep disorders such as obstructive sleep apnea. For instance, conditions such as type 2 diabetes, hypothyroidism and hypertension can be more common in women with obstructive sleep apnea relative to men. Several mechanisms contribute to these observations although some preclinical and translational human data implicate dysfunction of the immune system as a primary cause.

The overarching objective of the study is to determine if immune cell subpopulations, circulating markers of inflammation and cardiometabolic risk factors differ between women and men with obstructive sleep apnea.

A remote mindfulness-based physical activity intervention for postmenopausal women

Most adults in the U.S. do not meet the recommended physical activity guidelines, with physical activity decreasing by 40% to 80% during aging. Older women, who are already at increased risk of frailty due to accelerated muscle and bone mass loss from menopause-related hormonal changes, tend to be less physically active compared with older men. Increasing daily physical activity is linked to a slowing of aging-related bone loss and improvements in balance, coordination and muscular strength. However, current physical activity interventions are associated with several barriers, including time, access and self-efficacy. Such barriers block successful integration into patients' daily lives, limiting the likelihood of long-term participation.

Mindfulness-based interventions have been shown to be successful in addressing other issues in aging women. These include postmenopausal symptom management and lifestyle changes, such as diet, designed to improve health and wellness. Offering remotely accessible and physical activity-targeted mindfulness intervention tools may be suitable to address key barriers to physical activity interventions. Such offerings have shown promise with young to middle-aged adults. These tools can be easily utilized on a phone or tablet, allowing the patient to choose how and when to integrate exercise-based mindfulness into the day. The goal of this proposal is to investigate the acceptability of a remotely accessible mindfulness-based physical activity intervention for women as they age. The ability to elicit initial clinically meaningful physical activity changes as measured using wearable activity monitors would be tracked as well.

Differences in postprandial satiety among pre- and postmenopausal women with obesity

  • Maria (Daniela) D. Hurtado Andrade, M.D., Ph.D.
  • Funded by Mayo Clinic Women's Health Research Center
  • (5/2022-4/2023)

The etiology of obesity is heterogenous and not fully understood. As such, successful and sustained weight-loss outcomes with current treatment paradigms remain a challenge to achieve in clinical practice. This remains true for women in the perimenopause. The menopausal transition is associated with changes in body composition, resting energy expenditure and spontaneous activity. These midlife changes can add further to the burden of obesity and its associated risks in perimenopausal women living with this disease. The consistent worldwide sex disparity in the prevalence of severe obesity, with more women affected than men, strongly suggests that sex hormones are contributors to this sexual dysmorphism. Preclinical and clinical studies have inconclusively revealed that women-specific factors may affect two physiological determinants of obesity: energy expenditure and food intake.

The goal of this pilot project is to identify changes in postprandial satiety throughout the menopausal transition in women with obesity. An understanding of these changes could lead to the identification of therapeutic targets to prevent weight gain and enhance outcomes to weight-loss interventions in women through the menopausal transition.

Characterize metabolomic-wide and genome-wide biomarker signatures for appalling female preponderance of gallstone disease

Gallstone disease (GSD), also named cholelithiasis, is one of the most common and costly digestive disorders in adults worldwide. It presents in 10% to 20% of the general population, and strikingly, in more than 30% of Latina and Hispanic American women who are 40 years or older. Besides the morbidity and mortality associated with GSD itself, the individuals with cholelithiasis contribute significantly to the incidence and mortality of gallbladder and other digestive system cancers in the general population. Thus, precisely defining high-risk populations and properly managing patients with GSD can lead to reduced disease burden from not only gallstones in the short-term but also gallbladder cancer and other cancers in the long term. An appalling female preponderance of GSD has been documented for decades. The overarching goal of the two interrelated aims proposed in this study is to lay a foundation for developing effective strategies in early diagnosis and timely treatment of gallstone disease in high-risk populations. The ultimate objective is to identify the actionable targets in reducing gallstone disease, which in turn, could lead to significant reduction of the gallbladder cancer burden.

Combining genome-wide association studies (GWAS) and metabolomic data will be applied to identify genomic variants correlated with metabolic biomarkers as quantitative trait loci (QTL). To our knowledge, this would be the first study to combine metabolomic-wide and genome-wide variants to investigate the molecular underpinnings of sex disparities in frequency of GSD.

This investigation will examine whether gender disparity of gallstone disease can be explained partially by signatures derived from metabolomic-wide and genome-wide association in a Latinx community. This first study — as no published data exists on this topic — may detect novel metabolites signals or trend of differences among the predefined contrasting groups and between men and women. It's expected to yield clues in supporting cataplerotic generation of anabolic precursors for lipid, amino acid and nucleotide biosynthesis, as well as suggesting key metabolites essential for regulating the epigenetic control of gene expression and cellular signaling.

Genetic evaluation of hand erosive osteoarthritis

  • Andy Abril, M.D.
  • Funded by Mayo Clinic Women's Health Research Center in collaboration with Center for Individualized Medicine and Specialized Center of Research Excellence (SCORE) on Sex Differences
  • (7/2022-6/2023)

Erosive osteoarthritis is a phenotype of arthritis where joint destruction occurs to a larger degree than typical osteoarthritis, often limiting hand function in patients. The etiology is not understood, and immunosuppressive medications do not prevent progression. Studies have shown, and have anecdotally been seen in our clinical practice, that patients will often have a strong family history of severe arthritis, indicating an inheritable component. Also, a previous study has indicated there is familial clustering, more frequently following a maternal line of inheritance.

Erosive osteoarthritis can be debilitating for the patients who develop it. At this time, little is understood about the condition, and treatment is only aimed at symptomatic relief. Given the high suspicion for inheritability of the disorder, finding genetic irregularities in this population may allow a more complete understanding of the pathways that allow this advanced joint degeneration.

This study aims to evaluate the genomics of patients with erosive osteoarthritis to identify the genes that predispose these patients to such a severe phenotype of osteoarthritis.

A randomized controlled trial to assess the effect of music therapy on the anxiety of patients undergoing intrauterine insemination

  • Sarah C. Baumgarten, M.D., Ph.D.
  • Funded by Mayo Clinic Women's Health Research Center
  • (6/2022-5/2023)

Infertility is a common problem in the U.S., affecting approximately 1 in 5 women. These women, in addition to LGBTQI couples and women intending to single parent, may turn to intrauterine insemination (IUI) to conceive. While IUI may help patients achieve pregnancy, it turns a private and personal experience of conceiving in one's home into a medical procedure performed in the clinic.

This study is a randomized controlled trial designed to assess if playing music during IUI reduces anxiety that may be elicited by clinical procedure. Patients randomized to listen to music during the procedure choose the music they want playing from popular music streaming apps. If music reduces patient anxiety during IUI, it is a simple and inexpensive option that clinics could offer to patients during the procedure to improve their experience.