The experimental alternative that promises to delay menopause 20 years

• Research: Artificial 3D printing ovaries to recover female fertility

Hot flushes, palpitations, pain, frequent urination, insomnia, depression, anxiety, irritability. They are some of the symptoms of menopause, the cessation of menstruation when the woman finishes her fertile period and approaches old age. It is suffered by 90% of women and is caused by the progressive loss of female hormones produced by the ovaries. It occurs around the age of 51, although it may occur sooner or later.

However, for almost a decade, the scientific community points to the possibility of preserving a part of ovarian tissue when it is still young to implant it years later. This alternative, inspired by in vitro fertilization methods, can delay menopause up to 20 years from own hormones and avoid the complications of hormonal treatments. The technique is now being developed by a team of doctors from Birmingham, United Kingdom.

25% of women have no symptoms. For the rest, sometimes, it is accompanied by signs that need treatment, such as heavy sweating or a significant loss of bone mass (osteoporosis). To avoid this, there are hormonal treatments that restore estrogen and progesterone levels . It is what is known as Hormone Substitute Treatment (TSH). It usually improves the patient's health, but is not exempt from serious side effects . Some therapies have been linked to an increased risk of breast cancer, developing heart disease or suffering a stroke.

"Many women are constantly looking for different types of TSH that adapt better to their physiology, often with many visits to specialized clinics in menopause. This can be improved or relieved by having the tissue that produces your own hormones naturally," he explained to This newspaper Simon Fishel, a specialist in vitro fertilization and co-founder of ProFam, the company that has presented the latest results in this innovative treatment. The advantage of this therapy, he says, comes "by comparing a non-physiologically administered drug with the release of the body's own hormones, which are exquisitely controlled by the body's natural rhythms and the pulsatile release of these hormones," he said. Fishel

The process consists of extracting, when still young and healthy, a portion of ovarian tissue that is cryopreserved in the same way that fertility treatment samples are preserved, when what is wanted is to delay the age of pregnancy or allow It occurs in patients who have suffered cancer. The big difference is that this tissue will be grafted many years later, at the beginning of menopause and in a place in the body such as the armpit, which is a well irrigated area. This ensures that hormones can circulate throughout the body and avoid its annoying symptoms. Nor does it require the ovarian stimulation medications typical of fertilization, since it is only intended to restore hormonal levels.

According to the British media The Guardian , nine women have already followed this procedure, which costs between 7,500 and 12,000 euros . But, to be effective, you need a portion of ovarian tissue that is in good condition, it is not recommended for any age, or any woman. For which would this technique not be indicated? "For women over 40, women with low or poor ovarian reserve or women at risk of transmitting cancer cells within the ovarian tissue," Fishel told EL MUNDO. However, the doctor does not rule out that other types of cancer are considered for this procedure.

Researchers who have developed this method say that if performed on a healthy woman about 25 years of age, menopause could be delayed up to 20 years. The age at which the sample is stored is fundamental. The efficiency of the treatment depends on it, since the ovarian function is reduced during maturity and falls progressively as the woman's age progresses. If performed at 40 years, the limit for which its use is advised, menopause could be delayed only five years.

This is due to the fact that the duration of tissue function can vary, as well as the production of hormones once grafted, something that depends on the age at which it was cryopreserved, the cellular stress that is suffered in this process or the formation back again blood vessels that provide nutrients. For this reason, not all implanted tissues maintain the same periods of viability.

Advantages and disadvantages of treatment

Regarding the advantages and disadvantages of this technique, Dr. Sonia Lobo, gynecologist of the Obstetrics Service of La Paz Hospital, has stressed that with the increase in life expectancy, exceeding 80 years in the developed world, "more than one third of a woman's life develops in menopause, with the overall health effects that hormonal deprivation has in the long term: loss of bone mass, risk of fractures, genital and skin atrophy and mucous membranes. " For this reason, he stressed that increasing the normal functioning of the ovary "minimizes the effects of menopause and improves the quality of life of women."

According to the doctor, to understand the possible advantages of postponing menopause, it is important to highlight the double function of the ovary, reproductive and endocrine . The ovary produces ovules and hormones that affect other essential functions in a woman's day-to-day life: bone metabolism, development of sexual characteristics, vasomotor stability, libido or skin disorders.

As for how to know which patient might need this technique, Lobo has clarified that "you should suspect it in case there are risk factors for early menopause, whether caused by treatments that decrease ovarian reserve, such as chemotherapy, radiotherapy or history of ovarian surgery. " The gynecologist has also mentioned "the presence of risk factors for premature ovarian failure," such as "serious systemic diseases or women with a family history of early menopause.

They should not, however, those women who have " hormone-dependent tumors or are carriers of mutations such as BCRA1 and 2, which increase the possibility of suffering from breast or ovarian cancer. Nor does it seem advisable in women with benign pathology that depends on estrogen, as the presence of endometriosis or symptomatic myomas, "said Lobo.

As an inconvenience of this ovarian tissue cryopreservation technique, "it is important to highlight the possible disadvantages of this technique. It is invasive. It requires at least two surgical interventions , compared to the simple and cheap administration of pharmacological hormone replacement therapy," said Lobo. The technique itself can cause damage to the remaining ovarian tissue and, like Fishel, Lobo has also warned of the danger of reintroducing malignant cells in the case of women with tumors.

Today, despite the possibility of carrying it out as a treatment for the symptoms and consequences of menopause, "the only universally accepted indication of cryopreservation of ovarian cortex is as a technique to preserve fertility, before the first rule, in girls who have to undergo treatments that decrease their future fertility, both for chemotherapy, as radiotherapy or surgery.In women with advanced maternal age or low response, in which oocytes need to accumulate in numerous cycles of in vitro fertilization or women at risk of premature ovarian failure, it could be an option, but being aware of the lower functionality of the graft as the age progresses and the risks of performing the technique inherent in the surgical procedure, "Lobo concluded.

At the moment, the delay of menopause from ovarian tissue is considered by different scientific societies as an experimental technique . Only a small number of women have undergone this treatment, whose long-term safety is still unknown. Therefore, hormone treatments are the most practiced. On the other hand, there are studies that relate some food groups, such as blue fish, fresh vegetables, refined pasta and rice, with the age at which menopause appears naturally. Thus, the Nutritional Epidemiology group at the University of Leeds (United Kingdom) has published a 0.6-year delay in menopause in the Journal of Epidemiology & Community Health with a higher intake of vitamin B6 or 0.3 years related to zinc intake. In contrast, diets rich in carbohydrates carbohydrates were associated with an earlier age in natural menopause at 0.2 years among women 50 years or younger.

According to the criteria of The Trust Project

• Science and Health

Management The emergency chiefs alert by letter to Health of the saturation of their areas due to lack of workforce

Science US nuclear tests in the Marshall Islands have left more radiation than Chernobyl and Fukushima

THREATENED Borneo orangutan falls 30% in 15 years where there is oil palm cultivation