Longevity medicine tackles perimenopause: Here’s what it means for women’s health—and your clinical practice
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We must remember that although perimenopause and early postmenopause is a time of symptoms, it’s also a time of dysregulation of body systems.
—Karen Adams, MD
Longevity medicine is having a moment, and one major aspect of women's health is becoming increasingly central to the conversation.
Research suggests that menopausal symptoms can have a significant impact on future health and longevity, yet perimenopause continues to go underappreciated.[] “The big risk, of course, is failure to recognize and treat symptoms, which can cause a lot of discomfort and unnecessary suffering,” Karen Adams, MD, clinical professor of OB/GYN at Stanford University and Director of the Stanford Program in Menopause & Healthy Aging, tells MDLinx.
“We must remember that although perimenopause and early postmenopause is a time of symptoms, it’s also a time of dysregulation of body systems,” she adds.
The intersection of menopause and longevity
Increasingly, research suggests that the symptoms women experience during menopause can impact their future health and longevity. Diabetes, cardiovascular disease, psychiatric disorders, and reduced bone mineral density are associated positively with menopausal symptoms.[]
Authors of a 2024 systematic review argue that menopausal symptoms can be important indications of future health risk, and identifying groups at risk through proper symptom evaluation is critical for improving the long-term health of women.[]
New tech and perimenopause
The intersection of longevity and perimenopause may not be new, but tech companies have taken notice. A UK-based tech company has just launched a saliva swab genetics test for women in perimenopause.[] The company claims that its test combines genetics with hormone testing and that it can predict how a woman may experience menopause.
Related: Health tech has entered women’s health—but has the science kept up? One expert weighs inFor roughly $1,340, the company offers consumers individualized treatment recommendations based on their results.
But Dr. Adams says there isn’t enough evidence to indicate whether such a test is worthwhile. “Right now we do not have the science to support using genetics to determine perimenopause treatment strategies, so this approach is not evidence-based,” she says.
“The evidence-based way to approach perimenopause is to provide anticipatory counseling so that women know what to look for, and then create a treatment strategy based on shared decision-making, knowing that the path is not a straight line and that symptoms and treatment needs may change over time,” Dr. Adams adds
Related: Poor sleep, brain fog, mood swings? Perimenopause, explained: A clinical refresher for busy physiciansThe most important factor for longevity?
Dr. Adams argues that one of the best ways to manage perimenopause for longevity is to intervene earlier in life to help cardiovascular health and prevent things like hip fractures from occurring later in life.
“Women lose a significant percentage of bone density in the first 5 years after the final menstrual period, and intervention at that time is essential to preserve bone mass. Falling and breaking a hip is a disaster for an elderly woman: 1 in 4 will die as a direct result, and another 1 in 4 will be permanently disabled,” Dr. Adams says.
“So thinking about bone health early is key for health span. Fortunately, there’s about a 10-year window of time to intervene for the best impact on cardiovascular outcomes, so as long as women start treatments prior to age 60, they generally will get the benefits of hormone therapy on the heart,” she adds.