6 New Menopause Studies Every Woman Should Know About

So I'm doing something special today on Menopause Mastery. We're gonna go into some of the most recent studies that were published in the last 2 months. And I'm gonna start doing more of these because what I hear from all of my listeners and watchers on YouTube is that they're very excited about the fact that I share actual research. I stare at statistics, I walk through the nuances of that research and how to apply it to you. And there is quite a bit of research that is coming out or recently published that really doesn't get the headlines that it should. Actually, in most cases, a lot of times some of the dumber studies or the poorly designed studies get a lot of attention when even more important things are just lost to the journals. And as you know, I am a huge advocate for much more spending in perimenopause and menopause research. And, I'm driving towards that in every professional avenue that I have, particularly Minerva and the technology that we're building. But today, I'm going to talk about 6 studies that were published in peer-reviewed journals and that really looked at really strong research studies built well about reproductive biology, particularly around perimenopause, menopause, global epidemiology, and also new non-hormonal treatment candidates and/or just mechanisms that were found while the researchers were looking for non-hormonal treatment for different conditions around menopause. Now, the through line here is that this isn't less about new hormone data, it's more about the gap between what women experience And what truly gets measured, documented, and/or treated. And so, at a glance, let me just give you a rundown of what we're going to talk about. We're going to talk about the ovarian immune role, particularly that is amplified in menopause and post-menopause. And then, how many women, especially in lower economic status, experience early menopause? And, And when we look at education and women having education, interestingly enough, it also reduces their overall symptoms and the condition of menopause. We're going to talk a little bit about non-hormonal compounds that can help with vaginal atrophy and the genital urinary syndrome of menopause. And then what is really happening in women's conditions around perimenopause and menopause and why what you're often being told by your physicians Is way late in the game and the symptoms that are really appearing appear much earlier, but they're not what you think. And then the confusion around perimenopause, what it is, when it experiences, uh, different, uh, symptoms and what women really believe. And then last, we're gonna talk specifically about estrogen's role in the cannabinoid system in the brain and how it has an analgesic or pain-relieving effect and what the research shows. All right, so let's talk about the biggest one here because it got a little bit of heyday on social media, but I'm going to give at least my scientific spin on this. This was a study published July 1st, 2026 in Molecular Human Reproduction, and it was conducted by Frances Duncan and colleagues at Northwestern University. And what they examined were mouse ovaries at 3 different stages, 2 months reproductive, so Mice get reproductive super quick. And then, 18 months and 24 months, and at 24 months, they would be equivalent to a postmenopausal woman. They were using microscopic examination and bulk RNA sequencing. So, RNA is the software that your DNA produces. And, this is where they were looking to see what genes were activated or actively being expressed. Then, they cross-checked that pattern against a small Not yet peer-reviewed dataset of ovarian tissue that was from 28 postmenopausal women. So what does that mean? They pulled this data from mouse, uh, from, from mice, and then they also examined it from a database of 28 postmenopausal women and looked for the gene expression between the mice and the women. So what did they find? Post-reproductive mouse ovaries showed a marked increase in immune cell function. Specifically T cells, macrophages, and multinucleated giant cells. What does that mean? That means the cells that are often involved in immune regulation and fighting back on infection, and also that play an inflammatory level in even things like cardiovascular disease, like macrophages being implemented into plaques in your arteries, soft plaques, and they get pulled into that plaque structure underneath the fibrous core of a cholesterol plaque. But what they found was that the ovary appears to shift function. So instead of being egg sort of maturation farms where the eggs mature and the follicle pops open and the egg flies out, that it goes something closer to an immune inflammatory tissue. The human tissue data showed a similar shift. Hmm. To the mice, and especially in protein expression across age groups, lending to early support of the mouse findings. So why does this matter? This directly challenges the longstanding assumption that postmenopausal women and postmenopausal ovaries are biologically inactive. This is an early-stage animal study, and it's important to know that it— we can't make any clinical claims, but it's a great conversation starter to understand Why elective things like ovary removal at a hysterectomy may be a bigger decision than it's often treated. And it may open a new research thread on ovarian tissue and chronic low-grade inflammation in aging. So mouse biology doesn't map one-to-one to humans, right? So it's not a perfect match, and human data here is small and unreviewed. But this is an intriguing early signal and it's definitely not settled yet. So what are the ways we could look at this? So in one avenue, we could assume that the ovaries take on an immune regulatory effect infiltrating with T cells and macrophages and the multinucleated giant cells and that they become part of an immunomechanism. However, we could also look at this and say maybe due to the ovarian failure and the loss of estrogen, We have an infiltration of the ovaries by these immune cells, and that it may actually contribute to a low-grade inflammation state. We don't know that yet, but we could go both ways. Now, I look at it, and this is my hypothesis, the data isn't there to support or deny what I'm saying. But, if we look at some of the inflammatory states of aging, Yeah. Specifically, I mentioned it a few minutes ago and how as we age and we get cholesterol plaque activity in the arteries, and that's not like something getting shellacked to the inside of your artery, it's actually apolipoprotein B, which is a carrier of LDL cholesterol, pulls cholesterol into the arterial muscle tissue underneath the surface and then macrophages oxidized LDL and immune inflammation ramps up underneath that hard fibrous core. It starts out soft and then it becomes a hard fibrous core. And like, I'm going to give a really crass example, but it's kind of like a cystic zit. Like when you first get a zit, you can feel it. It's under the surface, not a lot happening. And then it slowly sort of erupts to the surface. And when it's erupting like that, it is unstable and it's full of inflammation. And that happens sort of in our arterial structure when you see arterial plaquing, and it's an inflammatory condition. So inflammation drives arterial plaquing, and then the plaquing itself is inflammatory. And we know that that ramps up in the loss of estrogen because estrogen protects the arterial structure, protects the tissue, and acts as an antioxidant inside the artery. And we see an acceleration of aging in postmenopausal women in the artery structures. As they go through menopause. That's why we have such an increase in cardiovascular disease in women postmenopausally because it accelerates that aging. So, if we look at that and we say, okay, our arteries have estrogen sensitivity, we have receptors for estrogen on those arterial structures, and we see a pro-inflammatory infiltration of plaque and macrophages in this area along with a pro-inflammatory state. To me, I look at that mechanistically and say, it is likely that the immune activity that we're seeing inside a postmenopausal ovary may be subject to the same inflammatory response and that it's not a— the ovaries just became an immune tissue. It may be infiltration of the ovarian tissue because of the loss of the receptor and hormone activity of the ovaries. And we see these immune cells Actually infiltrating the tissue. That remains to be seen, but it is a very interesting understanding that the ovaries are still important post-menopause and that, you know, removing them or not removing them during a hysterectomy, it's not just so simple as, well, you're not going to need them in a couple years anyway because you're going to go through menopause. We got a long way to go. But I thought that was a very interesting study and it helps us understand more and more The importance of our ovarian hormones. I think that's the big take-home message, and that we've got a lot of work to do here. Now, number two, we I talked a little bit about this in the very beginning. So they were looking at health survey data and demographic data that was cross-sectional analyzed, and they looked at a health survey data from 716,000 women, actually 716. 648, and they looked at women between the ages of 30 and 49 across 44 low to middle income counties, looking at how common early menopause and early menopause is classified before 45, and what demographic factors track with it. And what they found was about 7% of women, roughly one in 14 in the pooled sample, experience experienced early menopause, meaning they started the process, their symptoms showed up early. The prevalence was consistently higher as you moved into rural areas relative to urban areas. Now, here's where it gets a little more interesting. Women that were college educated were 58% less likely to experience early menopause. Delayed childbearing and formal employment were also protective. So Having children later in life seemed to reduce the amount of perimenopausal symptoms and the early onset, and also having formal ongoing employment, which is interesting 'cause that kind of conflicts with previous older studies when we pooled across all socioeconomic data. Now, if we look at the highest prevalence, so now we're moving outside of the United States. So this is worldwide. Ethiopia, 12%. Indonesia, 11.5%. Myanmar at 10%. These were the highest prevalence across communities. The lowest were Jordan, Gabon, and Armenia, roughly about 2 to 3%. So why does this matter? So menopause care is largely absent from global reproductive health and family planning programs, not just in the U.S. but everywhere, which tends to stop at contraception and pregnancy, meaning that once you're done having babies or that ship has sailed. Nobody's looking at it. Nobody's paying attention to it and nobody's funding it. This study is a call to fold menopause care, especially early menopause, which carries its own cardiovascular and bone risks into those same health systems. So we saw this across all, all different communities, but this is true also for the US because the reality is, is the earlier a woman goes through menopause, either medically or naturally, The higher the increased risk of cardiovascular disease is in those women. We have that data. It also increases our risk for osteoporosis and poor bone health because estrogen, progesterone, and testosterone have direct activities on the bone. Estrogen reduces how much bone gets reabsorbed and also informs the growth of bone. And then progesterone, especially cycling, and testosterone also do. And so this is especially important in all healthcare systems. And it's good material to understand that when we're looking at women's health, not only are we looking at reproductive health and our ability to be good moms and take care of families, when women are educated, when women have their own financial independence and good employment and the ability to control their childbearing years and beyond, not only do they have better experiences, Better family lives, and their community and families benefit. But it also reduces their risk of probably early onset menopause and the subsequent diseases that go along with it. All right, all right. Let's talk about a an animal model study that was done looking at a non-hormonal compound that actually regenerated vaginal tissue. This was Steve Norden and the University of Colorado and Schultz. Medical campus. All right. So, they synthesized a new nonsteroidal estrogen signaling molecule known as 3F. So, it's a signaling molecule that acts as if it was estrogen, but it is not a hormone. And, it's delivered as a vaginal suppository in animal models of menopause. So, that's how they delivered it. And then they examined the actual vaginal tissues for structural and functional recovery. So here's the thing: we get vaginal atrophy. It's terrible name. So basically what happens is the tissue in our vulva and vagina area dry up, get very very thin. We lose collagen production. We lose elasticity. We lose moisture, and that ends up causing painful sex and burning and other pain, and it can be extensive and. Quite painful, not to mention increase for genital urinary syndrome symptoms and UTIs and yeast infections. So when we look at genital syndrome of menopause, it affects a large share of menopausal women, and it's undertreated partly because some women can't or won't use vaginal estrogen. A significant portion of the problem here is because conventional medicine, despite Despite the standard of care recommendations that have now outlined that vaginal estrogen should be given to all women regardless of age, regardless of history, including breast cancer treatment, to protect against the genital urinary syndrome of menopause. Still to this day, insurance companies do not pay for it. Medicare does not pay for it. They don't pay for it to help reduce vaginal atrophy and UTI risk, which can cause sepsis and death. Leading cause of infectious death in women who are older. It's because we look at it and they're like, you know what? Women only need that to have sex. And guess what? They'll probably have sex even if it hurts, 'cause we don't care. So this can be helpful because especially in women who have breast cancer or who are under treatment for breast cancer, this is where the biggest disparity happens because physicians are still uninformed. About the safety of vaginal estrogen, or women are frightened of using the very low-dose vaginal estrogen that can protect them. And there's stigma around discussing it at all. So this compound works through a different mechanism than estrogen and is truly potentially novel because it could help in women that are just resistant or not willing to take vaginal estrogen. Now, this is again an animal model, but this 3F compound actually restored the epithelial or the tissue on the vagina itself. And it's a possible option, not necessarily a true treatment available now. So that's kind of cool. I am still a huge fan of vaginal estrogen. Every woman should be on it from now until the day they die, especially if they're perimenopausal onward, because it does reduce our risk for urinary sepsis, And everything else on top of it. All right. Now we know that there's a disparity here because you're my listeners, but you know, there's a big disparity between what women say on things like Reddit and you know forums and what they tell their doctor. So this was actually a JAMA article discussing the divergence in menopause symptoms and narratives between what's happening online and what's being experienced. Experienced in the clinical setting. And this was actually an AI-assisted comparative text analysis. So they used AI to analyze especially the Reddit threads and then look at what really happens within the medical system. And so researchers used this AI-based natural language analysis to compare 2 large text sources. So more than 2,000 electronic health records from the UC San Francisco database medical records and then Reddit's all-time top 999 posts from menopause-related forums. From there, they analyzed 646 detailed clinical notes and 577 Reddit side posts side by side. Here's what they found. Now we already have data that proved this before. My friend Andrea Donsky actually published in the Menopause Society in this. Correlates strongly with it. So, key findings, cognitive symptoms, brain fog, fatigue, memory issues, emotional well-being, and weight changes came up 3 to 4 times on Reddit compared to the clinical documentation. Now, that coincides with Andrea Donsky's research and the symptom research that has been published in the last couple years. So, the truth is perimenopause shows up as a neurological disorder long before a hot flash and a night sweat. And then most women are experiencing that and experiencing it early. So what does it mean when it shows up in Reddit but not in the EHR documentation? Either they're not being listened to, they're frightened to have the conversation, or they're being dismissed. Now cognitive impairment specifically was discussed about 20% more on Reddit but documented only about 5% of clinical visits. Clinical notes, by contrast, were more reliably capturing hot flashes and night sweats and treatment discussion. Now, as somebody that's been in the industry for 22 years, I can tell you right now, I doubt that that's because that was the symptom that showed up the most. It's because the doctors honed in and focused on hot flashes and night sweats, because that's what they think perimenopause to menopause symptoms are. And those show up late, significantly after the cognitive function. This is strong evidence that clinicians are systematically under-asking about, under-documenting, and under-supporting women when they come to their office with brain fog, depression, mood, anxiety, weight changes, and they're being dismissed even though patients are clearly experiencing it and discussing it at length elsewhere. As the researchers put it, electronic health records tell us what medicines and bills for. Online communities tell us what patients live, and we need both. And a natural thing to look at now is the disparity, the disparity between what gets paid for and what gets documented and what women are really experiencing. And this is why you can't have a 10-minute visit to help a woman through perimenopause and menopause. The current medical system is broken, and the group that pays the biggest price are women and especially midlife women and beyond. And it's really a sign because the reality is there was another post earlier this week by the Menopause Society complaining and lamenting about women going out on social media and following influencers when the reality is, is they are unable to have the nuanced conversation about hormones and the perimenopause to menopause transition. They have provided zero capacity to help women understand it. They aren't getting information implemented into clinical experience, medical schools, and/or medical training. And the reality is, is women are floundering to try and find this information and they're gonna turn to social media. And that's where people like myself and Dr. Kelly Caspersen and all kinds of other people are out sharing the information so you can be educated. All right. Now, this follows in the same results. So 1 in 3 women don't know they're in perimenopause. This is from the Journal of the Menopause Society, and this is was published July 15th, and it was the exact name of it in case you want to look it up was exploring the prevalence and drivers of perimenopause uncertainty among U.S. women—a mixed method study. So this was a survey of over 7,600 U.S.-aged women between the ages of 35 and older asked whether they knew. What reproductive menopausal stage they were in, and for those who didn't, why? Right? So this is pretty astounding when you think about it. 34% were uncertain about their reproductive stage overall. They weren't clear about where they were. That uncertainty peaked at about 42% for women in that 40 to 44 range. Again, I would say this is because we've been told repeatedly. Even today, with a traditional physician, that hot flashes or night sweats are what you're supposed to pay attention to. And again, the symptoms that we see early are all neurological. Three drivers accounted for the confusion: symptom confusion and misattribution, which was 56% of the time; knowledge gaps—we just have gigantic gaps because medicine isn't providing the value that's necessary for women's care—and the barriers to getting a diagnosis. A, doctors will throw their hands up and say, we can't test for that, we can't know that, and just tell you it's all in your head or it's something you have to grin and bear. Younger women, especially 35 to 39, were more likely to cite knowledge gap, whereas women 40 to 44 were more likely to say that they were having barriers to getting care as a whole. And I would say there's probably multiple reasons for that last one. I would say women who are in that still productive, potentially reproductive time period are probably having more regular gynecological visits. Whereas as we get a little bit older, we have a little less access. And especially if we're not thinking about reproduction planning or reproduction management, that's where we start to see a little bit of that. But the simple fact is it's a challenge to actually get in, to find a practitioner that actually will sit and listen and help you navigate. Which is why we created Minerva in the first place. So this is probably the most important relatable part of the study. A full third of women in the target demographics can't confidently say what stage of perimenopause, menopause, postmenopause they're in. And it's not because they're not paying attention. It's a mix of misleading symptom expectations and misinformation from the medical system. It's an information gap and a friction in the healthcare system. And this is how you actually need to know, right? And again, the stuff that shows up early are the things that they tell you is all in your head, right? All right. Now my next study, the last study, this is in rats, but this is pretty interesting. And I've known about this for a long time. We had some other historic research that looked at this, but what they're looking at is CBD, right? So CBD is a compound found in hemp plants. That is not the THC or the mind-altering psychotropic part of it, but CBD matched estrogen's memory protective effects. Now, if you listened to me before, you know that estrogen has a memory and cognitive function effect that is protective. And as a matter of fact, 3 out of every 4 Alzheimer's patients are women. And it's not just because we outlive men, we actually have a much greater estrogen-related risk Alzheimer's compared to men because of the loss of estrogen at menopause. Now, the researchers from the University of São Paulo actually did this study and they were looking at preclinical animal models. So what they did is they took female rats and they either went through an ovariectomy, so they took their ovaries out to model menopause, or they did a sham surgery, meaning they sort of messed with them but left their ovaries in. Then received 21 days of daily CBD. So they gave 10 milligrams per kilogram, which would've been the equivalent of what you would give to an adult human. And so in, in the group, you know, they either had that or estradiol or a, a control group that had nothing at all. Memory was tested via object recognition and fear conditioning tasks. So we, rats are actually really smart. And they, they will recognize things. So they recognize mazes, they recognize items, and they can also be conditioned to do tasks usually in a fear-based model. So, you know, it's the Pavlov's dog sort of thing, but they, they will do tasks to avoid whatever uncomfortable stimulus. And then they did this alongside hippocampal cannabinoid levels. So basically looking at the hippocampus in your brain, And looking at the endocannabinoid levels and the gene expression, right? So they looked inside the brain at the cannabinoid activity and then they looked at the actions that the, the rats were able to do. And what they found was CBD produced memory improvements on the objective recognition task comparable to those seen with estradiol, right? So estradiol protective to hippocampal function, right? Yeah. Right? CBD also protective to memory and memory improvements and memory function. So both equally helpful. Both CBD and estradiol reversed memory impairment caused by the ovariectomy. So when they removed the ovaries, guess what? The ones with the removed ovaries that weren't getting CBD or estradiol, they performed more poorly on all cognitive tests. The rats, right? But both CBD and estradiol treatment actually reversed those memory impairments, and CBD reversed expression of several genes—the FAAH and MGLL enzymes—that break down e-cannabinoids and the endocannabinoids as a whole, raising the hippocampal endocannabinoid levels in a pattern. similar to hormone therapy, right? So, why does this matter? So, this is a rat study. It's not a human trial, but it points to the endocannabinoid system that is rampant in the brain as a possible non-hormonal pathway to support memory during the menopause transition. Now, of course, I look at that and go, okay, we already have established options with estradiol and we know that estradiol can be protective to the brain. Right. However, we know from at least some of the imaging studies and the early clinical studies that that protective window of estradiol is in that first 10 years because the brain ages, the hippocampal activity shrinks. We get changes in the neural pathway mapping and a dimming of the engine of the prefrontal cortex. All of those things happen in menopause and estrogen when introduced basically staves off that activity. So what'd be interesting and cool, but we don't know yet, is in a woman who may be significantly past, let's say, menopause, and maybe we've lost that window of opportunity for estrogen, but maybe, just maybe, CBD, because of its similar action in the brain, may be somewhat restorative. We don't know that yet. We can't tell, but they both work on similar, similar mechanistic activity. So it might be an avenue to study whether a CBD analog or a CBD support could improve cognitive function in women who are, you know, a decade or more outside of menopause, or even in addition to estrogen therapy in women who may be on hormones but still concerned about cognitive function. It's very interesting. This is something to watch. It's by no means a recommendation. It's Definitely something that I, I'm interested in because I already knew that estrogen had an analgesic or pain-relieving effect through the cannabinoid system. And this is just another place that we see it. All right. So why is, why are all these important? You know, here's the thing. We have small studies trickling in. We have studies trickling in all the time, but the reality is, is only 15% of studies actually get published. And so when there is a study that gets published and women over 40 only get 1% of research dollars, we need a lot of fanfare and attention to every single one of those studies because what gets attention gets paid. And so the more I can help you understand the studies that are out there and where the research is going, the more you can help raise awareness with your friends and family so we can actually help support women's health. That's the whole reason why we're building Minerva. We're building a technology platform to become the largest longitudinal database of women's health so we can actually do our own studies and research. But until that point, I feel strongly that we want to support the research that's out there, and I want to make sure you understand it. So, today's episode was all about the most recent studies and how you can apply that knowledge or at least understand where the industry is going. And I hope you found it helpful. And if you happen to be listening to this podcast on your favorite podcast platform, please don't forget to give us a 5-star review. That helps us get known. And if you happen to be watching this episode of Menopause Mastery on YouTube, don't forget to subscribe and leave a comment in the comment section. This helps us figure out what our next topic will be and who our next guest will be. And I want to thank you for listening to Menopause Mastery or watching it on YouTube. Because when we know more, we can do more, and together we rise.