Innovations in Women’s Health Research Aim to Make Menopause Optional

Daisy Robinton, PhD, co-founder and CEO of Oviva Therapeutics, joins Pharmacy Times to discuss her presentation about women’s health and female longevity at the Livelong Summit, happening on March 15 and 16 in West Palm Beach, Florida. According to Robinton, there is a growing body research being done to understand female reproductive health and physiology. She highlights the importance of the ovaries, which are a female’s “seat of health in many ways,” the effects of menopause and reduced ovarian function, and discusses common menopause treatments and the necessity for new innovative therapies. You don’t want to miss this discussion.

PT Staff: What will you be presenting on at this year's Livelong Summit?

Daisy Robinton, PhD: I'll be speaking in a session that's called “Fired Up About Female Longevity,” which is really about efforts to boost women's health, extend fertility, and health span. I'll also be running a breakout/breakthrough session on fertility and innovations happening in that space, [during] which we'll talk about current standards of care, near-term innovations happening, and longer-term exciting things that are coming on the horizon.

PT Staff: Indiscussing women's health, or the health [of a person of any] gender or sex where they have female reproductive organs, what does the research landscape look like right now?

Daisy Robinton, PhD: It's very interesting because for the last (all of time!) [rather] 50-plus [or] forever number of years, female physiology has not been something that has had much focus. It was only in the last handful of years that we've really seen a lot of change happen there a lot of recognition that there is a unique physiology for people that are born with female reproductive organs and double ‘X’ chromosomes, and that presents not only potentially different paths to diagnoses for certain diseases, but also different prevalence of different diseases, and maybe the same diseases will manifest differently in a male person versus a female person. And, the way that we respond to therapeutic interventions is different, not to mention that we also have some unique needs that only women or people with ovaries and a female reproductive structure have, including things like menopause.

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What I'm very excited about is that, in the recent years, there's been a lot of attention in the space [and] a lot more funding coming into this space. Probably many people saw that there was a recent announcement from the White House to put $100 million dollars of funding towards women's health research. So there's a lot of effort going to close the gap in terms of what do we understand about male physiology, and what can we (or should we) know about female physiology so that women can have better care. [In addition, it will also help to] understand their bodies better and understand their health better and navigating the complexities of one's health throughout a person's lifetime.

PT Staff: Can you explain to me a little more about what is menopause? What does it look like physiologically? How does it affect our health and quality of life as we start to age?

Daisy Robinton, PhD: Menopause is something that will happen to every person born with female reproductive organs. The average onset for women in the United States is age 52. Menopause is really defined, retrospectively, as 12 months without menses (or without a period. Really, what it marks it, in many ways, is a fundamental shift in a woman's physiology because her ovaries are no longer functioning at the same level that they have been.

Menopause really marks the end of that reproductive period and the end of our fertility. So, in many ways, it's been thought of really in that capacity of when you stop being able to have babies. I think there's been a lot of overlooking of the fact (and actually a lack of appreciation of the fact) that our ovaries and a woman's body are really the seat of health in many ways— the hormones that they produce provide a sort of homeostasis or consistent quality of life during a woman's reproductive years, if her reproductive organs are functioning sort of in a normal range.

Kind of on the whole, the ovaries themselves are really important for maintaining health across a number of parameters. When we approach menopause, a lot of the hormones that are produced by our ovaries start being produced somewhat erratically. And really, I think is the inflection points of menopause itself.

On the other side of that is where we see a whole host of negative health consequences happen for women. We see that once a woman goes through menopause, she has significantly increased risks of cardiovascular disease, very significant declines in neurocognitive health (so many women experienced ‘brain fog’) and there can be increases in anxiety, depression, mood disorders, [and] a lot of sleep dysfunction. As many folks in your audience know, sleep is also a very important foundation for general health and well-being with the immune dysfunction dysregulated glucose metabolism, sexual dysfunction and increased incidence of osteoporosis.

So there's a whole constellation of health consequences that result when our ovaries stop working in the way that they have been for the vast majority of our lives. And the last thing that I'll say is that, about 100 years ago, life expectancy was roughly 56 years of age. As I mentioned, the average onset of menopause is age 52. So, spending a few years in menopause I'm sure wasn't pleasant, but it wasn't the same kind of math, so to speak, as today, when we're living into our 80s.

Women are spending 42% of their lives post-menopausaly, and importantly, our 50s are, for many women, a real peak in their life: [it’s a] peak in their career, they have kids at home, they're often caring for their older parents, and it's just a bad time to go through a significant disruption to your relationship with your body and your relationship with the world— what you can bring to your work and your family and the relationships you care about.

PT Staff: What kind of treatments are [women in menopause] being given, and how are [women] meant to get through menopause? What are research efforts trying to innovate and change about the current landscape of treatment?

Daisy Robinton, PhD: In today's world, there's a lot more resources now for women than there were even 5 years ago. A lot of those are taking shape in the form of kind of community tele-health organized companies like Evernow [and] Midi Health, which are specializing in bringing resources in a centralized location for women who are in the perimenopausal years—I'd say probably age 42 and up (although some women go into menopause early)— and being able to connect them with resources that are useful so that they can identify some of the symptoms that they may be experiencing and connect with providers who can guide them to navigate those symptoms.

I think that's important because again, most physicians aren't trained. And actually, when you look at surveys, many [physicians] expressed a discomfort in, or lack of readiness, to actually help a patient who's experiencing perimenopause or menopause. It is really quite shocking. So with that said, there are additional resources and kind of infrastructure growing to support care for women.

Obviously, I think most people are aware that HRT (hormone replacement therapy) as like the main line of therapeutic intervention for women who are approaching menopause or are in menopause. And that's something that I think is a fabulous tool that, unfortunately, from the Women's Health Study (now [conducted] 20-plus years ago [and] had a lot of publicity that sort of misconstrued the data) made a lot of physicians reticent to prescribe it and made a lot of people afraid to take it because of what they perceived as very high risks associated with that treatment, which we now know of have largely been sort of debunked. The benefits of an HRT treatment far outweigh the risks in most cases. HRT is really the best therapeutic option for women (… replacing estrogen and progesterone in a woman because those are hormones that get depleted over time as you approach menopause, and when you're in menopause).

That being said, there's a number of other lifestyle interventions [and] supplements that are on the market, and I think there's a pretty high variability in terms of what's actually effective (and what has evidence behind it to show supporting improvement in one's experience of symptomology).

But I think what's exciting is that we're increasingly thinking about menopause, not as something natural one must endure, but something that is a medical need— that we can innovate around. And certainly the work that we're doing at Oviva therapeutics looks to the ovaries as fundamental to our health and well-being, and has the goal of being able to preserve ovarian function for a greater period of time so that we can extend health span for women and make menopause something that can be optional through therapeutic intervention.