AUSTIN, Texas—A University of Texas at Austin College of Pharmacy researcher has received a $1.4 million grant from the National Institutes of Health (NIH) to study how the brain may play a role in controlling the timing of menopause.
Dr. Andrea Gore is one of several researchers who are realizing that a deeper understanding of the brain's role in reproductive failure is needed to help in the creation of new therapies.
"For too many years, the focus in menopause research has primarily been on the ovaries," Gore said. "Although there is no question that the ovaries are key to the menopausal process, it was puzzling that there was little interest in whether the brain may also have a role.
"After all, the brain drives reproductive function during the rest of the life cycle, including puberty and adulthood, and the brain is a target organ for the major ovarian hormone, estrogen."
Many of the menopausal complaints—hot flashes, depression and memory issues—that prompt women to seek treatment are neurological in origin, she said.
Gore looks at the mechanisms by which the brain controls reproductive development and aging, primarily looking at a group of neurons in the area of the brain (the hypothalamus) that synthesize and release a hormone that is the primary molecule controlling reproductive function.
"During aging, how do these cells change and do they become dysfunctional?" she said.
Changes in the brain occur earlier than changes in the ovaries, said Gore, adding that this is evidence that brain changes contribute to driving the changes in the ovaries.
"By understanding how normal brain processes change during aging," she said, "we can intervene when things go wrong. Although menopause is a normal part of aging, it is accompanied by numerous symptoms that affect the quality of life in most women."
Basic neuroscience has a great deal to contribute to the clinical issues surrounding estrogen, menopause and the aging brain, Gore said. "But until now, few have appreciated the connection."
There are many questions to be answered, including whether or not menopausal women ought to take hormone therapy to treat their symptoms.
"This is a question that individuals need to discuss with their doctors," she said. "An important consideration is the age at which hormones are taken, because this determines if the outcome will be beneficial or harmful."
Her research will have clinical implications for postmenopausal hormone replacement therapy and for identifying non-hormonal approaches to treating menopausal symptoms. There also are clinical implications for potentially expanding the reproductive lifespan.
"The subject of expanding the reproductive lifespan has become more important as women continue to postpone childbearing until later in life," Gore said. "Women often find that they suffer from age-related declines in fertility that make conception difficult or impossible."
Interesting, too, she said, is the fact that at the turn of the past century, both life expectancy and the average age of onset of menopause for women in America was slightly over 50 years old. Women can now expect to live until 80 years of age, although the average age of menopause remains in the early 50s.
"So, it is more important than ever to understand the links between the brain and the ovaries, and the causes and consequences of aging on the functions of both of these organs," Gore said.
Funding for the five-year study titled "Hypothalamic Control of Reproductive Aging" is from the National Institute on Aging of the NIH.