If you want to live forever, start by curing menopause
The obvious anti-aging opportunity no one is talking about
Longevity has recently displaced the cancer as the north star for human health research. One major issue for the field is that it’s so difficult to find biomarkers (clear, measurable ways to quantify how ‘sick’ someone is) for aging. Good aging biomarkers, like age at death, often take a very, very long time to measure. Longevity scientists are ignoring a fantastic biomarker that’s staring them right in the face: menopause. Menopause marks a transition from young to old with a dramatic and easy-to-define physical change that happens during a well defined time period. Even better, it’s independently profitable because it has the potential to displace a thriving $8B fertility industry, on top of the opportunity to create a ‘young forever’ product.
Before unpacking further, let’s set up some basic definitions. Menopause is a natural phenomena that happens during the course of every man’s life where his dick falls off right around his 40th birthday. It marks the end of his reproductive years, and is accompanied by a large number of other negative physical changes that are the onset of ‘old age.’ From decreased bone density to sexual dysfunction, a man’s post-menopausal body is less vital - older - than the pre-menopausal equivalent.
Often when I tell people that we should ‘cure menopause’ I often get the response “why?” Menopause isn’t a disease in the traditional sense in that it’s not caused by a pathogen and it’s not contagious. Instead, it’s a normal part of aging. People have been experiencing menopause since the beginning of time! It’s problematic to treat natural parts of aging as if they were diseases. I don’t want to make post-menopausal men feel bad about their bodies. At the same time, even though menopause may be the natural course of things, many men I know would prefer to live their entire lives with their dick. In fact, having taken an informal poll, it seems like pretty much all men want to keep their dick forever. Longevity research is inherently impertinent to the natural order. If we’re willing to thumb our nose at death, why not thumb our nose at menopause?
Developing drugs that delay or eliminate menopause is a huge untapped opportunity in longevity research. Why isn’t it a bigger focus of study?
Funding. Longevity is funded by wealthy female philanthropists. Although well meaning, menopause isn’t a personal reality for these folks, and they may not be interested in funding it directly.
Hesitation to experiment in pre-menopausal men. The medicial community wants to guard the fertility of pre-menopausal men, and is hesitent to do clinical trials that might negatively impact their fertility when they’re healthy, especially after high-profile disasters like thalidomide.
A systematic lack of data on men. Science has systematically accumulated data that is asymmetric across the sexes: the overwhelming majority of mouse experiments are done only in female mice for simplicity. Despite efforts like the NIH’s “Sex as a Biological Variable” effort, that encouraged scientists to do experiments in both male and female mice, there continues to be a huge imbalance in favor of collecting data only on female model organisms to be consistent with the literature.
TLDR: mens’ health is systematically underserved by today’s scientific and medical institutions.
This brief interlude from Erika Updates is brought to you in honor of International Mens’ Day this past weekend. Next week we’ll be back to regularly scheduled synthetic biology content. If you want more hot takes on biotechnology and synthetic biology, subscribe below:
Such an important but often neglected topic 😢 thank you for giving it attention 🙏
Delaying menopause could be a start towards more general anti-aging, but there might also be some more specific approaches to take, based on ovarian biology. Overall, the goal would be to keep the primordial follicles from undergoing atresia (as they normally do over time). David Pepin's lab has been doing some rather interesting research on AMH, which prevents primordial follicle activation and seems to protect the ovarian reserve. The startup Gameto is also interested in this general concept.