Can You Actually Delay Menopause?

Even though it’s a natural part of a woman’s reproductive lifespan, menopause can be a lightning rod for emotional reactions. Some women are thrilled to have their periods come to an end, along with the risk of having an unplanned pregnancy. Others dread the prospect of hot flashes, night sweats, mood changes, and other unpleasant symptoms related to menopause.

Meanwhile, still others worry about increased health risks—for conditions such as osteoporosis, heart disease, and dementia—that can come with the loss of ovarian function and the dramatic decline in estrogen levels that occur after menopause. That’s partly why some scientists and cultural influencers believe that delaying menopause may be a key to longevity.

“The ovary ages faster than many other organs, and often even faster than the woman herself,” says Dr. Zev Williams, director of the Columbia University Fertility Center and chief of the division of reproductive endocrinology and fertility at the Columbia University Irving Medical Center. “Today, as women enjoy longer lives, extending the functional lifespan of the ovary could have a meaningful impact on long-term health and quality of life.”

It’s a controversial proposition for various reasons. “The idea of delaying menopause doesn’t make a lot of sense, because we’re not talking about fertility and women’s periods,” says neuroscientist Jennifer Garrison, co-director for the Center for Healthy Aging in Women at the Buck Institute for Research on Aging in Novato, Calif. “The real conversation should be about preserving the part of ovarian function that’s related to health. The benefit of giving women options for preserving the endocrine function of ovaries will be to maintain a consistent quality of life for a number of years.”

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Indeed, some people believe (without proof) that delaying menopause could extend women’s lifespans and healthspans. “There isn’t evidence that this is a fountain of youth,”  says Dr. Stephanie Faubion, medical director of the Menopause Society and director of the Mayo Clinic Center for Women’s Health. “ At the end of the day, it would be super cool if we could make the ovary not time-out, but I don’t know how we could do that, and we don’t know what the potential downsides are.”

Even so, the very idea has led some scientists to investigate whether menopause can be delayed in healthy women, and how that might be done.

One approach—mostly used in cancer patients—involves surgically removing pieces of the ovary and freezing them, then re-implanting the thawed tissue years later to restore ovarian function. In a study published in a 2024 issue of the American Journal of Obstetrics & Gynecology, researchers predicted that for most women under 40, ovarian tissue cryopreservation and transplantation would result in a significant delay in menopause.

“It is currently most applicable for women who are having cancer therapy that will destroy their ovarian tissues,” says Dr. Nanette Santoro, professor and chair of obstetrics and gynecology at the University of Colorado School of Medicine. “Most of the applications are for fertility and not for extending the age at menopause by keeping the ovary functioning."

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With another approach, researchers at Columbia University have been investigating the use of the immunosuppressant drug rapamycin, which is typically used to prevent organ transplant rejection, in delaying ovarian aging. The goal here is not necessarily to extend fertility but to slow the rate at which the ovaries age.

Preliminary studies in mice show that rapamycin can decrease ovarian aging by 20%. The team of researchers is currently investigating whether these benefits translate to women. “As promising as these early developments are, it’s important to wait for the results from the ongoing VIBRANT study to determine whether rapamycin is both safe and effective for delaying ovarian aging in women,” says Williams, who is co-leading the study.

In the opinion of Santoro (who is not involved in the study), “this would have its most immediate application to women facing early menopause. We know that menopause prior to age 45 has adverse health consequences. So getting everyone up to age 45 [for menopause] would probably result in a net benefit for population health.”

Meanwhile, some companies are working to develop new drugs that could slow ovarian aging. “The challenge with any new drug is demonstrating its effectiveness, ensuring a favorable safety profile, and addressing cost and production hurdles,” says Williams. “The advantage of repurposing a drug like rapamycin is that it has been widely used for decades, meaning its safety profile is well established and it is available at a relatively low cost.”

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Still, even if it were possible, further research needs to be done to determine whether it actually makes sense to extend the ovarian lifespan beyond the “normal” age at menopause, which ranges from 45 to 55, Santoro says. “There will likely be upsides and downsides; it would delay the onset of osteoporosis for women [who are] at risk, might reduce heart disease risk, and might reduce the risk of dementia. But this would have to be proven before it was applied to the entire population.” 

On the other hand, possible tradeoffs include an increased risk of developing breast cancer, uterine cancer, and blood clotting events, Santoro says. This might happen because a woman would be exposed to estrogen for longer. 

“There are also many women who will not want to continue having menstrual periods.” For example, women with fibroids, painful periods, endometriosis, menstrual migraines, and severe premenstrual syndrome “often find menopause to be a blessed relief,” she adds. Aging—even of the ovaries—sometimes has its perks.