What if we could delay menopause?

Most women understand menopause as a natural, inevitable life stage, similar to going through puberty. According to the Menopause Society, the average age of menopause — when you have gone 12 consecutive months without a period — is 51 to 52 years old in the United States. The phase leading up to it, perimenopause, can span from just a few months up to a decade.

The thing is, 52 doesn’t feel like it used to, and many 52 year-olds don’t feel “ready” for menopause. More women in middle age are interested in delaying the process to reduce the time they may have to deal with post-menopause health issues. The most common symptoms during menopause, like hot flashes, can be uncomfortable, but can also be well-treated with menopausal hormone therapy (MHT) and a good fan. What’s trickier to manage are the significant, long-term health impacts from menopause, such as osteoporosis, cardiovascular disease, and joint pain, among others. Now, some researchers are looking into whether menopause can be delayed to keep women feeling their best for longer. Here’s what they’ve found.

While some women will breeze through perimenopause and menopause, others will experience the full gamut of symptoms. The menopause transition brings a steady decline in estrogen and progesterone, and those dips have a ripple effect throughout the body. The most commonly reported issues are vasomotor symptoms like hot flashes, night sweats, sleep disruption, mood changes, and brain fog. 

“Beyond these symptoms, falling estrogen levels increase the risk of osteoporosis, cardiovascular disease, and changes in metabolic health, including weight redistribution toward the abdomen, and genitourinary symptoms (like vaginal dryness and urinary urgency). Frozen shoulder, joint pain, and increased UTI risk are also extremely common but underreported,” says Dr. Lora Shahine, M.D., a Seattle-based OBGYN and reproductive endocrinologist. 

While there are many symptoms you will clock early on, often more serious health issues like diabetes, osteoporosis, heart disease, and even dementia won’t show up for another 10 to 15 years, says Dr. Laura Gemmell, M.D., a reproductive endocrinology and infertility fellow at Columbia University’s Fertility Center. 

While menopause is a reproductive milestone, says Shahine, the fact that it can also have a significant impact on women’s long-term health is why some researchers have become interested in how they can delay it. The key to doing that seems to lie in the ovaries. “Ovaries can act much like the brain in the sense that they have a Wi-Fi kind of communication with lots of other tissues in the body,” says Jennifer Garrison, Ph.D., a scientist at the Buck Institute who shifted from focusing on brain research to women’s health. “At every age, not just at menopause and not just with respect to fertility, if you’re female, your ovaries really dictate a lot about your health. When they’re not working, it changes your health risk profile.” 

The hormones like estrogen and progesterone produced by the ovaries have a protective effect on the heart, bones, metabolism, and brain, says Gemmell, and when ovarian function fizzles around menopause, those protective effects do too. 

Every woman is born with a finite number of eggs. And while that number declines through their lifetime, the rate of decline speeds up in their thirties, which means the ovaries tend to show age-related changes before any other organ. “Some researchers view the ovaries as a kind of aging clock for the female body,” says Shahine. “Maintaining healthier ovarian function for longer could therefore have downstream benefits for bone density, cardiovascular health, brain health, and metabolic regulation.”

The notion of delaying menopause is less about extending fertility and more about extending women’s healthspan (which is differentiated from lifespan as not just calendar years, but years spent in optimal health without chronic issues). Garrison says the term “delaying menopause” is “nonsensical” because it tethers a discussion about ovarian aging to menstruation and fertility. Instead, “what we’d like to understand is how ovaries function normally — and how that function changes as a consequence of your age, your genetic risk factors, and your environmental exposures — and to be able to use that information to maintain health at every age,” says Garrison.

Though women live longer than men, they often have a shorter healthspan and spend their later years contending with chronic disease; menopause is a tipping point. “The hormonal changes associated with menopause speed up cellular aging by roughly 6%,” says Daisy Robinton, Ph.D., a molecular biologist and entrepreneur, adding that women spend around 25% more time in poor health than men do. “ Studies show that mortality in women is reduced by 2% for each increasing year at the age of menopause, meaning the later you go into menopause, the longer you are likely to live.”

Oviva is one of the companies focused on ovarian aging. Their approach, says Robinton, hypothesized that elevating levels of AMH (a naturally occurring hormone produced by both men and women) could reduce the number of eggs lost with each cycle, thereby “saving” them. 

The biotech firm Celmatic is reportedly developing a drug that aims to slow ovarian reserve depletion, and Gameto is engineering ovarian support cells culled from stem cells to help stall menopause. 

Two of the more buzzed-about approaches to delaying ovarian aging are cryopreservation and the drug rapamycin. Cryopreservation, which, says Shahine, is already used in onco-fertility before cancer treatment, involves freezing a woman’s ovarian tissue when she is young and transplanting it back to restore hormonal function, though this requires surgery and comes with the risk of reintroducing malignant cells. Then there is rapamycin, an immunosuppressant that was part of a recent Columbia University Fertility Center study called VIBRANT that explored whether it had the potential to delay ovarian aging. 

“Typically used to prevent organ transplant rejection, rapamycin has recently become a central focus of research on aging and longevity,” says Gemmell. Because of how rapidly the ovaries age, the drug’s impact could be measured more quickly. “Early results from the [not-yet published] VIBRANT study suggest that it’s possible for rapamycin to decrease ovarian aging by 20%.”

Broadening a fertile window for women who want biological children later in life is significant too, though it can raise issues. “Extending fertility without also slowing overall aging raises real ethical concerns, including higher obstetric risks, questions about parenting capacity, and the very real possibility that these interventions could deepen health disparities if they remain accessible only to the wealthy,” says Shahine.

There is also the question of whether prompting the body to produce estrogen longer could raise the risk of developing estrogen-dependent cancers. Women with a family history of estrogen-receptor-positive breast cancer or endometrial cancer would need careful evaluation, says Shahine, adding that rigorous clinical trials with long-term safety follow-up would be essential before any intervention aimed at prolonging ovarian estrogen production moves into widespread use.

What the research does already consistently show, says Shahine, is that women who experience menopause later (after age 50 and particularly in their later 50s) tend to have lower rates of cardiovascular disease, better bone density, and, in some studies, longer overall lifespans. Scientific advancements aside, though, there is plenty that women can do to help set themselves up for the healthiest menopause transition possible. Smoking, very low body weight, a history of disordered eating, and extreme exercises without adequate caloric intake have been connected with earlier menopause onset, says Shahine, adding that chronic high stress and poor sleep can also negatively affect ovarian reserves over time. 

To have a healthy, timely menopause transition, pay attention to your body in the years leading up to it and understand what your baseline is. “Tracking your menstrual cycles and noting any changes like irregular periods, hot flashes, sleep issues, or mood shifts can give you and your healthcare provider valuable information,” says Gemmell. She often has women keep a symptom diary.

Making lifestyle shifts like strength training, getting enough protein, managing stress, and prioritizing adequate sleep — key tenets of the Weight Watchers for Menopause Program — can improve how you feel during and after the menopause transition. For the issues that do emerge, hormone therapy remains, says Garrison, the best, albeit widely underused, treatment. Though it should not be used solely to prevent long-term conditions, MHT “can meaningfully reduce many menopausal symptoms and provide some of the health-protective benefits of natural estrogen, particularly for bone and cardiovascular health when started early in the transition,” adds Shahine. 

If the ovaries hold the key to how women will age, what we need is far more robust research focused on their function. “The truth is we have such a huge disparity in data and knowledge,” says Garrison. “Most of what we know about ovarian function comes from what happens when you take them away or when they’re not working.” What the conversation around delaying menopause may reveal above all is a crucial need for more information and more dollars earmarked for women’s health research. Particularly as more women, around 1.3 million in the U.S. each year, continue to enter menopause. 

“The goal is not to define a single correct way to get older,” says Shahine, “but to give women informed choices and genuine agency over their own health.”

Why does the timing of menopause matter so much for long-term health? Because estrogen acts as a natural shield for a woman's heart, bones, and metabolism. When ovarian function declines, that shield drops — causing blood vessels to stiffen, bone density to decrease, and metabolic risks like diabetes to rise. The goal of new longevity research — like ovarian tissue freezing and anti-aging drugs — is to delay menopause and reduce chronic disease. Until those treatments are ready, the most effective ways to protect your healthspan are lifestyle adjustments like managing stress, getting enough sleep, solid nutrition, strength training, and starting MHT early in the transition, all of which Weight Watchers for Menopause supports in one holistic program.