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 recommend that menopausal hormone remedy (MHT) might profit mind ageing in females and scale back their dementia danger. Nonetheless, not all females present reminiscence advantages when taking MHT. The primary objective of my analysis is to grasp why there’s such a diversified 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 often not accounted for in analysis. By accounting for the assorted types of MHT, in addition to different organic and way of life elements, we purpose to make clear why some, however not all, females present reminiscence advantages when taking MHT. Our objective is to maneuver towards personalised or precision drugs, and establish efficient formulations of MHT that may assist wholesome mind ageing 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 shortly.  We have been inspired to confer with the textbook for extra element, moderately than having the subject prioritized in lectures. This expertise made me understand that girls’s well being isn’t given the eye it deserves. Fortuitously, 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 infinite potentialities inside this space of analysis, and made me understand that female-specific well being elements are literally one thing that may make your analysis extra fascinating, moderately 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 give attention to ladies’s well being analysis throughout my undergraduate research, then my graduate work, and that’s how I ended up right here at present.

Are there any findings that you would be able to 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 the next danger for breast and ovarian cancers. Sadly, early ovarian most cancers detection strategies 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 really helpful as early as 40 years outdated, a number of years earlier than spontaneous/pure menopause. 

There may be 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 better danger for dementia with out MHT. In our analysis, we recruited midlife ladies, averaging of their mid-40s, to evaluate adjustments in reminiscence, sleep patterns, and mind operate, whereas additionally evaluating the results 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 knowledge factors, we noticed that for some people estradiol-based MHT works rather well. For others, it’s not 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 assessments 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 knowledge, would enable me to discover how people understand their reminiscence adjustments and may present wealthy insights that numbers alone might not seize. Even when somebody doesn’t rating low on a quantitative measure, their subjective expertise is actually precious. I hope to include this qualitative perspective into my future work.