Behind the Science: Decoding Menopausal Hormone Remedy

Interviewee: Dr. Laura Gravelsins, Postdoctoral researcher, College of Toronto, Centre for Habit and Psychological Well being |Authors/Editors: Romina Garcia de leon, Janielle Richards (Weblog Co-coordinators)

Revealed: October eleventh, 2024

Are you able to inform us a bit of bit about your analysis?

There’s a big physique of literature to counsel that menopausal hormone remedy (MHT) could profit mind growing old in females and scale back their dementia threat. Nevertheless, not all females present reminiscence advantages when taking MHT. The principle aim of my analysis is to grasp why there’s such a assorted cognitive response to MHT. MHT is available in many varieties, for instance, it varies in dosage, formulation, route of administration, and timing of initiation. These many types of MHT are normally not accounted for in analysis. By accounting for the varied types of MHT, in addition to different organic and life-style elements, we goal to make clear why some, however not all, females present reminiscence advantages when taking MHT. Our aim is to maneuver towards customized or precision medication, and establish efficient formulations of MHT that may assist wholesome mind growing old in all females. 

What led you to do that work? 

I believe the place it actually began is in my undergraduate research. I used to be taking a physiology course which was very content material heavy. We reached the unit on feminine reproductive physiology and I keep in mind it was skimmed over rapidly.  We had been inspired to seek advice from the textbook for extra element, relatively than having the subject prioritized in lectures. This expertise made me notice that girls’s well being isn’t given the eye it deserves. Happily, across the identical time, I stumbled upon a analysis article by Dr. Emily Jacobs that explored the interactions between the menstrual cycle and dopamine ranges, and the way these interactions have an effect on working reminiscence. This was the primary article I encountered that mixed a female-specific issue with neuroscience. It opened my eyes to the countless potentialities inside this space of analysis, and made me notice that female-specific well being elements are literally one thing that may make your analysis extra fascinating, relatively than be a complicating or nuisance variable.  I believe I used to be very fortunate to have had this realization at this stage in my analysis journey. This motivated me to concentrate on girls’s well being analysis throughout my undergraduate research, then my graduate work, and that’s how I ended up right here as we speak.

Are there any findings you could share with us? 

My PhD analysis centered on females with surgically induced menopause, particularly these with risk-reducing bilateral salpingo-oophorectomy (BSO) as a result of they carry a genetic mutation that places them at a better threat for breast and ovarian cancers. Sadly, early ovarian most cancers detection methods are poor, so one of the best preventative possibility for these people is to get their ovaries eliminated after they’re fairly younger. BSO is beneficial as early as 40 years previous, a number of years earlier than spontaneous/pure menopause. 

There’s substantial analysis indicating the significance of ovarian hormones for mind well being in later life. Earlier research, together with work from Dr. Walter Rocca’s lab, have proven that females with bilateral oophorectomy could also be at larger threat for dementia with out MHT. In our analysis, we recruited midlife girls, averaging of their mid-40s, to evaluate modifications in reminiscence, sleep patterns, and mind perform, whereas additionally evaluating the consequences of estradiol-based MHT. General, we discovered that estradiol-based MHT benefitted working reminiscence, sleep, and hippocampal quantity, however was not absolutely protecting. When plotting particular person information factors, we noticed that for some people estradiol-based MHT works very well. For others, it isn’t as efficient. 

What’s subsequent for you and your analysis?

My background has been primarily in quantitative analysis, so taking a look at efficiency metrics from neuropsychological exams and reminiscence assessments, and quantifying mind volumes and hormone ranges to grasp people. I’m hoping to include extra qualitative elements into my analysis subsequent. Adopting a mixed-methods method, which mixes each quantitative and qualitative information, would enable me to discover how people understand their reminiscence modifications and may present wealthy insights that numbers alone could not seize. Even when somebody doesn’t rating low on a quantitative measure, their subjective expertise is de facto priceless. I hope to include this qualitative perspective into my future work.