Scientists are still trying to figure out why human ovaries have a shelf life — and how they can extend it. Celia Ford, Future Perfect Fellow at Vox, joins host Krys Boyd to discuss a new breakthrough that promises to delay menopause, what that means for healthy aging in women, and what the social implications might be if older women are still able to bear children. Her article is “We have a drug that might delay menopause — and help us live longer.”
Can we slow down aging by targeting the ovaries?
By Madelyn Walton, Think Intern
Many researchers have been speculating why ovaries have an expiration date. The science is rapidly changing, so we don’t have all the answers yet, but some say we may be pretty close.
Celia Ford is a Future Perfect Fellow at Vox, and she joined Krys Boyd on “Think” to talk about her article “We have a drug that might delay menopause – and help us live longer.”
Ovaries, it turns out, control a lot of functionality in the human body.
“But we know that once they start to decline, we see a lot of other risks of chronic diseases start to increase,” says Ford.
In the final stretch of reproductive years, humans go through menopause. Menopause comes with side effects such as hot flashes and mood swings, and ultimately results with the end of the menstrual cycle. However, the end of these reproductive years comes with other potential challenges such as Alzheimer’s and strokes.
“If we delay menopause, we can prevent higher-risk disease and worsening health conditions in women,” Ford says.
Enter rapamycin, an immunosuppressant used to aid organ transplant patients; now there’s new research that says the medication may be beneficial for anti-aging and an extended reproductive cycle. Scientists have considered administering a low dose of rapamycin to humans to see if ovarian aging slows down.
Ovaries tend to age much faster than other organs in the human body, so the hope is that rapamycin can slow down their growth and delay menopause by a few years.
“What it seems to be doing is communicating with the molecular signaling pathway and changing the way that cells are telling each other to grow,” says Ford. “Or I think in this case, not to grow.”
The effectiveness of this medication could be life changing for those that want to extend their reproductive years.
“I don’t think that it’s the kind of thing that would make it so that you could have a totally 100% risk-free pregnancy forever,” she says. But, the thinking goes, it could open the door for women that want to have children a few years later.
Rapamycin’s anti-aging benefits have not necessarily been proven in human studies, largely due to logistical issues, Ford says.
“It’s really hard to prove anything about aging in humans just because of how long we live,” she says.
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Transcript
Krys Boyd [00:00:00] If you have ovaries high five. In addition to their reproductive function, ovaries, production of estrogen and progesterone helps keep bone, brain and heart cells healthy. But there is a limit on those benefits because for reasons we still don’t fully understand, ovaries age faster, even in perfectly healthy people than the rest of our organs. But maybe they don’t have to. From Kera in Dallas, this is Think I’m Krys Boyd. The faster timeline of ovaries years of function makes them very interesting to scientists studying the mechanisms of aging in humans. And some people think an immunosuppressant drug called rapamycin might have the potential to keep them humming along for several years beyond the typical age of menopause, potentially expanding the window of women’s fertility and even the number of years of overall good health. Celia Ford has been reporting on this. She’s a future perfect fellow at Vox, where you can find her article “We have a drug that might delay menopause and help us live longer.” Celia, welcome to Think.
Celia Ford [00:01:04] Hi. Thank you so much for having me.
Krys Boyd [00:01:07] It’s not just odd that ovaries age faster than other organs. It’s odd that it only happens in a handful of mammal species. Right?
Celia Ford [00:01:15] It is super weird. Everybody that I spoke to about this said that menopause is a very biologically strange thing, and we’re not 100% sure why we do it at all. But it really is just humans, maybe a couple of other primates and a handful of whales and that’s it.
Krys Boyd [00:01:34] And, you know, it might seem like it’s a factor of being a mammal that lives a long time, but elephants live for many decades and their females don’t lose fertility early. Do scientists have any good hypothesis for why menopause exists at all?
Celia Ford [00:01:51] There’s one hypothesis that people have that maybe there’s some benefit to having older females in social groups who are beyond their reproductive years. But other than that, it still is an ongoing, unsolved mystery in science.
Krys Boyd [00:02:09] It turns out ovaries are interesting to senescence researchers, people who study aging precisely because they seem to be out of sync with other human organs.
Celia Ford [00:02:20] Exactly. Because the hardest thing about studying the aging process in humans is because humans live a pretty long time, way longer than a normal science experiment would go on for, or would be able to get funding for. So being able to study an organ that ages way quicker than the rest of the human body is kind of logistically convenient because you can do experiments on a shorter time scale using human tissue. So it lets you get around doing things like studying mice instead, which is another common practice in longevity research.
Krys Boyd [00:02:57] We should note, just to be fair, men do see a decline in fertility over time, but it’s a gradual process, right? Rather than the kind of binary that exists for women before and after menopause?
Celia Ford [00:03:09] Right? Yeah. Because when men age or I should say people who have testes age, testosterone declines. But it’s over a more gradual period of time. But for people with ovaries, the decline in estrogen kind of happens really erratically around the time of perimenopause, which for most people begins sometime around their 40s and can last anywhere from a few months to a few years. And then you do get this very sudden drop off in estrogen levels, which causes a whole slew of physical problems that we’re also only just beginning to understand.
Krys Boyd [00:03:50] That term perimenopause seems to be out there in common parlance in a way that it wasn’t a couple of decades ago. And maybe it’s because a couple of decades ago I was far away from the age of any of this. But this refers to the years well before actual menopause, right, when the ovaries start misbehaving.
Celia Ford [00:04:10] Yeah. So I think that perimenopause is referring to this period of intense estrogen fluctuation as the ovaries are kind of starting to change and decline in function. And menopause itself, I think, only refers to that specific day when you no longer are having periods. So perimenopause is basically all of the changes and the symptoms leading up to that time when periods stop, which is menopause.
Krys Boyd [00:04:41] For a long time, scientists were mostly interested in female reproductive organs based on their ability to reproduce. But ovaries, of course, are good for more than that. What do they do besides releasing eggs every month?
Celia Ford [00:04:57] So scientists are really only just beginning to understand this because people have historically really neglected studying women’s reproductive health in a scientific capacity, especially outside of thinking about reproductive organs for the sake of reproduction. One of the researchers that I spoke with, Jennifer Garrison at the Book Institute, she suspects that the ovaries might be really important as just like a pacemaker for the aging process in people who have ovaries. They seem to communicate with a really wide range of other organ systems in the body. And we’re really only just beginning to understand like what exactly it is that the ovaries seem to be talking about with all of these other organ systems. But we know that once they start to decline, we see a lot of other risks of chronic diseases start to increase. So they must be important for a lot of things.
Krys Boyd [00:06:00] Is there any relationship between the age at which a person would naturally experience menopause and the aging of the rest of their bodies, Like does earlier or later mean anything?
Celia Ford [00:06:11] It seems like yes, at least looking at correlations. So there are some studies that suggest that going through menopause at a younger age is associated with a higher risk of things like Alzheimer’s disease or osteoporosis later in life. But again, I think that people really are only just beginning to study in detail why it is that these changes might be related to each other.
Krys Boyd [00:06:40] Absent any disease. Do we know why the age of menopause varies? Like what? Signals ovaries to either keep going or quit?
Celia Ford [00:06:51] I really wish that I knew the answer. And I so I myself have more of a background in neuroscience prior to being a journalist. So I am not myself a reproductive longevity scientist. But from talking with the people that I spoke to for this article, it sounds like this is still an active area of research.
Krys Boyd [00:07:11] Talk a little bit about what we do know about the ovaries, communication with the brain and with the rest of the body.
Celia Ford [00:07:17] So we know that parts of the brain communicate with the reproductive system to regulate things like hormone production. And we also think that estrogen, which is a hormone, seems to also function as a neurotransmitter. So as a chemical that sending signals to cells inside of the brain. And people are still trying to figure out what exactly estrogen is doing in the brain. But it seems to have some kind of a protective function because there have been studies showing that declines in estrogen are associated with greater risks of developing neurodegenerative disease. So neuroscientists are starting to suspect that maybe estrogen has something to do with protecting cells from having problems, communicating with each other, keeping them healthy. But again, we’re really just not very sure how they work, because research in this field has just historically been so underfunded.
Krys Boyd [00:08:21] Women or people who have ovaries, if you like, still tend to outlive men or people who have testes, if you like, broadly speaking. But I guess one problem is that women spend more of those extra years in a frail health state.
Celia Ford [00:08:39] Exactly. Yeah. So it seems like women do tend to outlive men by a number of years, but they tend to have greater risks for things, especially like osteoporosis. So changes in bone density that can lead to increased risk of injuries like falls or broken bones. People tend to have higher risks of neurodegenerative diseases like Alzheimer’s disease. So people are really trying to understand and like why it is that women tend to live longer but maybe have a worse health span. So the number of years that you can live autonomously and in good health.
Krys Boyd [00:09:22] What makes scientists think that delaying menopause by a few years might extend that health span for women, even if it doesn’t necessarily give them more years of life?
Celia Ford [00:09:34] Right. Well, again, we’ve seen a lot of correlations and studies between people who go through menopause later in life and people who tend to have longer health spans. And the reverse is true as well. People who seem to undergo menopause earlier seem to have higher risks of all of these age related chronic conditions like strokes or heart disease or neurodegenerative disease. So I think the reasoning is that if we can delay menopause, if those correlations have some meat to them, if there’s something underlying that, then maybe we can extend healthspan by warding off whatever molecular changes are happening in the body to make those increased health risks happen.
Krys Boyd [00:10:22] Hormone replacement therapy has been available for decades now to treat. Generally, it’s used to treat some of the symptoms of menopause. But I guess the catch is in the title there, you’re replacing hormones. You’re not like starting up the ovaries all over again.
Celia Ford [00:10:38] Exactly. And hormone replacement therapy can be effective for certain people, especially people under the age of 60 and in limited amounts. But there are some risks that are associated with hormone therapy as well, including an increased risk of breast cancer. So it’s something that can be really effective if done appropriately. But overdoing it can actually increase some of the health risks that you’re trying to avoid. So it’s a it’s a very tricky balance of. Yeah. And I think that part of it is that you’re not kickstarting the ovaries back into gear again. You’re replacing a hormone kind of externally, which is not the same.
Krys Boyd [00:11:22] So there have been discoveries in the past that seemed to promise the possibility of delaying aging, but which have subsequently proved disappointing. Why was there excitement around these protein cells called sirtuins?
Celia Ford [00:11:39] So sirtuins, well. They lend themselves well to be a thing that one would get excited about because they’re a compound that we can find in red wine. And people love to read studies that say that drinking red wine is good for you because that’s just you know, that would be convenient for a lot of us, if true. But it’s a pretty classic problem in science that things that seem promising in studies in animals end up not panning out in humans because there’s only so much that we can extrapolate findings in animals like mice who are genetically kind of similar to us but are, you know, when all is said and done, quite different. Sometimes things that we find in mice don’t actually translate to humans. And it turns out that a lot of the early data in the studies of this protein’s sirtuins was actually probably a lot of publication bias, a lot of people fudging their results a bit. A lot of those papers have since been looked back on critically by scientists from the field.
Krys Boyd [00:12:51] Even outside the scientific community. You can imagine, I’m sure as a journalist, like how excited people were to put that headline in newspapers and magazines without necessarily revealing the full nuance of what was found and not found.
Celia Ford [00:13:06] I think, again, like if somebody sees a headline like “The Secret to a Long, Healthy Life is drinking red wine every day,” that’s juicy. You would love to get that headline to your name. And the science is just really complicated. And if you are not in the lab doing it yourself, sometimes it can be really tricky to understand how a study is actually done. Sometimes the press releases that are associated with the release of these scientific papers and these paywalled hard to read journals don’t make it obvious that the study was done in mice or maybe even in worms or in yeast. So it becomes tricky to interpret like how related to humans where these results really. So it’s it’s tricky trying to interpret things. And science is always a messy, nonlinear endeavor.
Krys Boyd [00:13:58] Sylvia, just to go back to what we were just discussing, there are people who get very fed up with science because, you know, in this year you have all these headlines that seem to say one thing and then two years later you have all these headlines that say, wait, we found more information. To me, that’s kind of the beauty of science. But I guess we all need to understand how it works, right? That what appears to be true, the fact that a few years down the road something else is revealed about it doesn’t necessarily mean we should never trust science.
Celia Ford [00:14:31] Absolutely. And I think that that’s one of the trickiest and least emotionally satisfying things to embrace about the process of science, is that, well, the trickiest part about science is that nobody knows what the right answer is. And the process of converging on the most true thing is usually pretty messy. Sometimes you try one thing and maybe it seems promising that time, but then maybe another research group somewhere else will try to do the same thing and it doesn’t work. And then they’ll realize like, it’s because we did this one small thing differently. And maybe that uncovers a teeny tiny piece of information that will add to bringing you one inch closer to the truth. But it’s almost never like one person somewhere says eureka. And they found the deepest ground truth of how the earth works. Science very rarely works that way. So when you see a study come out that is really excited about one thing and then a decade later it seems like that thing isn’t true anymore. It’s often not because scientists are trying to pull a fast one on people. They’re not lying. It’s just that they hadn’t found the truth yet. And that can be a really frustrating thing to embrace. But unfortunately, that’s how science works. It’s just a process of ongoing discovery and truth finding. And I also think that that’s the most beautiful thing about it.
Krys Boyd [00:16:02] It’s also beautiful because it means science has never finished learning, right? Nothing is ever entirely settled. Even things that appear to be very obvious to us?
Celia Ford [00:16:12] Absolutely not. Nothing is ever completely settled. And sometimes we end up finding things that totally turn on their head, things that we thought were 100% true, which again, I think is a beautiful thing. It means that we’re never finished learning.
Krys Boyd [00:16:27] So sirtuins are no longer the darling of the anti-aging research community. The emphasis has shifted to these other proteins known as MTOR. M-T-O-R. What do MTOR proteins do in our bodies?
Celia Ford [00:16:43] Yeah. So MTOR is part of this signaling pathway that seems to tell cells all around the body when they should grow and when they should stop growing. So as we get older, MTOR activity seems to start changing because as we get older, things in our cells in general start to go a little bit haywire. Our gene expression starts to get weird and the DNA damage that results from that can make it harder for cells to work properly. But what this MTOR signaling pathway does is basically tells cells when they should be spending more energy and when they should be saving energy. So taking a drug that interacts with those proteins can potentially dial down that cell’s growth signal, which can give the cell the chance to clear out whatever garbage it had been accumulating over time and help it run more smoothly and effectively.
Krys Boyd [00:17:46] Just a little tangent here. I mean, you know, we worry about aging in our bodies, no longer working as well as they once did. But the kind of programing within our bodies that tells them what to do when is a remarkable thing. It occurs to me, you know, we just take for granted that at some point we stop growing. Right. But if we didn’t, we’d be in a lot of trouble.
Celia Ford [00:18:09] Absolutely. Yeah. It turns out that all of this is very finely orchestrated. Gazillions of cells talking to each other, gazillions of tiny things inside of your cells, talking to each other, making sure that we grow as much as it makes sense for us to. And then we stop once it would be bad for us. And sometimes that process doesn’t go perfectly, but it goes pretty well for most people. But it does seem like the process of aging is, at least as far as we know, pretty built into the way that not only human’s body or human bodies work, but how all bodies work.
Krys Boyd [00:18:49] So now we get to this drug that could offer a new form of defense against aging. I don’t want to hedge too much here, but based on our earlier conversation, we always want to make sure that people understand this is still in the experimental phases. Rapamycin, right, is already out and on the market, but what is it used for currently?
Celia Ford [00:19:09] Right. So rapamycin communicates with these MTOR proteins and a fun fact is that MTOR actually stands for the molecular target of rapamycin. So rapamycin binds to these. And it’s a drug that was derived from some really niche bacteria that are found uniquely in the soil of Easter Island. So super random, random little drug, but it tempers MTOR activities. So it kind of helps cells save their energy, clear out their garbage, which seems to help soothe overactive immune systems. So right now, rapamycin is approved by the FDA as an immunosuppressant drug that people take if they get an organ transplant. And they need to make sure that their bodies don’t reject the new organ. So this drug is actually already approved by the FDA as something that’s safe for humans to take and effective for at least people who need it after an organ transplant. And it’s pretty cheap. It’s a generic drug. It’s not super expensive. But the thing that people are intrigued about is that beyond this organ transplant function, it seems to also, at least in studies in animals help, animals live longer. And people are still trying to figure out, again, exactly why that is. But it seems to have something to do with affecting this MTOR pathway.
Krys Boyd [00:20:48] When you say help animals live longer. You’re not just talking about animals that received an organ transplant. This has been given to animals independent of that.
Celia Ford [00:20:56] Exactly. Yeah. So in studies in animals like mice and worms, you can give mice this drug, mice who have not had an organ transplant or anything otherwise like, quote unquote wrong with them. And it seems to help them extend their lifespans by something like 15%. So it adds like a not nothing number of weeks to their lifespan. We haven’t been able to demonstrate this same effect in humans because, again, studying like whether a human’s lifespan is extended or not by giving them a drug, if you think about it, is really hard to do in a scientific setting because we live so long and so many things happen to us over the course of our lives, it’s very tricky to figure out whether taking one drug was the thing that made somebody live to be 91 instead of 90. Like, who knows? But at least in animals, it does seem to be promising.
Krys Boyd [00:21:56] So that’s why human studies of ovaries might be particularly useful in this case, right? Because we know that ovaries have, for lack of a better word, an expiration date.
Celia Ford [00:22:08] Exactly. Yeah. Ovaries seem to age much faster than most other organs in the human body, and it gets around some of the problems of doing studies in animals like lab mice, because lab mice also don’t live very long. So you can study the aging process in them. But they’re mice, so they’re not humans. So the good thing about ovaries is that they are part of a human, but they age very quickly, quickly enough that you could study them in a reasonable amount of time in the lab.
Krys Boyd [00:22:44] Do people who take rapamycin after an organ transplant, I mean, obviously they have sort of lifelong health concerns that other people don’t have. But has anyone noticed anecdotally that they age in some ways more slowly than their peers?
Celia Ford [00:23:00] So I’m actually not sure. But I do know that because the drugs seems to be safe at the dose that people would take it if they’re prescribed this drug. And there have been some human studies of people taking it at lower doses. It seems to not have too many side effects, although the you know, the cost benefit analysis is different from person to person. But there are people out there that take rapamycin at low doses weekly just in case it might work. But I’m not I’m not sure whether we’ve seen anything in organ transplant patients specifically.
Krys Boyd [00:23:45] So there’s research now to see whether rapamycin might be able to delay menopause by a few years. Just to reiterate, this is not a hormonal therapy like HRT, right?
Celia Ford [00:23:59] No, this is not a hormonal therapy. It doesn’t have much to do with estrogen itself at all. What it seems to be doing is communicating with this molecular signaling pathway and changing the way that cells are telling each other to grow. Or I think in this case, to not grow.
Krys Boyd [00:24:21] So you mentioned that in animals studied with rapamycin, their lifespan can be extended by about 15%. What do we know about how long rapamycin could extend the kind of working life of human ovaries?
Celia Ford [00:24:36] So we’ve seen some studies again also in lab mice that show that rapamycin prevents the activation of these immature egg reserves. So it keeps more of the not yet released eggs healthy for longer. So at least in lab mice, rapamycin does seem to prolong ovarian function. And we’ve also seen evidence that MTOR suppressant qualities of rapamycin improve some of the symptoms of age related chronic diseases in humans. So kind of given the combination of those two things that at least in lab mice, rapamycin seems to be keeping ovaries healthier for longer. And in humans it seems to be improving some of the symptoms of chronic disease. Some scientists figured maybe it would be worth it trying to give a low safe dose of rapamycin to humans that are nearing the upper end of their reproductive years to see if they can slow ovarian aging.
Krys Boyd [00:25:43] I’m not looking for absolute specifics here, but I’m curious as to whether when rapamycin is administered in a lab setting to research animals like mice. Does this happen like from the time they are juveniles? Does it happen when they’re getting close to what would be considered old age in a mouse, or is there a variation?
Celia Ford [00:26:05] I think that it depends study to study. But I think that most of the time this would be done in a reproductively mature mouse. But beyond that, I don’t know the specifics.
Krys Boyd [00:26:19] So if we could delay menopause in humans, it is potential that we could extend the window in which people could conceive and bear a child. But even if rapamycin keeps human ovaries working longer, do we know yet whether that protects the eggs those ovaries contain from age related damage.
Celia Ford [00:26:42] So the first clinical trial on this is currently underway and the results haven’t been published yet. But one of the experts that I spoke to suspects that while this would extend people’s reproductive fertility for longer, it would make it possible to have a baby one year a few years older. It probably wouldn’t prevent the the kind of genetic mutations that we tend to see in older eggs. So even if you could be fertile in your, say, mid to late 40s, more likely than you would if you weren’t taking this drug, it probably wouldn’t necessarily prevent your eggs from having the same risks that they otherwise would if they were old, which is the same for sperm as well.
Krys Boyd [00:27:34] So it’s probably not something that people should assume will give them unlimited fertility. If they want to wait, they might still need to freeze eggs or plan to have children at the sort of typical ages.
Celia Ford [00:27:47] Yeah. So I don’t think that it’s the kind of thing that would make it so that you could have a totally 100% risk free pregnancy forever. I think that the thing that the researchers leading this clinical trial are most excited about is that it could probably delay menopause by about five years, which given trends in the way that we’re having children, is changing a lot more. Women are waiting until they’re a little bit older in their later 20s, early 30s, late 30s to have their kids and adding an extra five years to that could be really meaningful. And beyond extending fertility again, delaying menopause by a few years maybe could extend healthspan kind of beyond our reproductive concerns. You know, it could prevent risk of things like osteoporosis or neurodegenerative disease, which is also a huge deal.
Krys Boyd [00:28:44] It is interesting that osteoporosis, it affects both people in female and male bodies, but it tends to be much worse for women, despite the fact that men have never had the amount of estrogen that women’s bodies have. Do we know why that is the case?
Celia Ford [00:29:02] Women, unlike men, have this very sudden drop in estrogen levels around the time of menopause. And we know that estrogen is important for maintaining bone health. But it’s worth saying that everybody is bodies, regardless of gender, do produce estrogen.
Krys Boyd [00:29:18] Yeah, A lot of the things that we once believed, like testosterone, is for men. Estrogen is for women. We’re learning now that everything is for everybody. Like they may be different in present in different quantities, but they’re there in all human bodies.
Celia Ford [00:29:34] Exactly. All people have all the hormones just in different quantities.
Krys Boyd [00:29:38] So this is obviously all in the experimental phase for now. Is the general thinking, though, Celia, that something like rapamycin would work for people who start it around the time of menopause? Or would they probably begin to need the need to begin taking that medication years earlier to slow the decline of ovarian function?
Celia Ford [00:29:59] So the pilot study that’s going on right now is in women between 35 and 45 years old. So around that time, that might be either right before or maybe even during what we’d call perimenopause. So that ramp up and the symptoms, that kind of signal that menopause is on its way. So kind of towards the end of your prime reproductive years. But part of that is because since it’s a clinical trial and people are volunteering to do this, it’s less risky. Like if something if something bad were to happen, then people would be kind of towards perimenopause anyway. So it’s less likely that for a clinical trial people would be recruiting women say, between 25 and 35. But I imagine that it’s the kind of thing that you would take before menopause begins.
Krys Boyd [00:30:54] Celia, immunosuppressant drugs are a miracle for transplant patients. Lots of people didn’t survive before they existed. They do come with side effects and with tradeoffs. What have researchers done to try and refine the dose of rapamycin that might work for purposes of delaying aging while sparing people the side effects of the sort of dose that you need if you’ve had a kidney transplant?
Celia Ford [00:31:21] Right. So if you’re taking a drug like this to potentially delay aging or to prevent some of the side effects of aging, then you probably would take less than you would if you were using it as an immunosuppressant, because suppressing your immune system too much is obviously not ideal. And we’ve also seen some some case studies of people who have taken higher doses of rapamycin where it actually can cause fertility problems. So the exact opposite of what people have been trying to study here. So over clinical trials, people will tinker with the dose that people are given right now, people who take rapamycin for its potential anti-aging benefits usually take a really small amount, only about five milligrams per week. So not even taking it as something you would have every day. And the dose that’s being experimented with in this ongoing clinical trial to see if rapamycin can slow ovarian aging is also a very low, not daily dose, because people want to kind of squeeze all of its anti-aging benefits out without risking any of the potential fertility or immunosuppressant problems that could come with it in a higher dose.
Krys Boyd [00:32:44] These kinds of therapies are always exciting to think about, but they can also be controversial because menopause is not at the moment considered a disease state. Nor is aging per se. Could that debate be an impediment to access if indeed we discover widespread anti-aging effects from rapamycin?
Celia Ford [00:33:06] I think it could not only be a problem for access, but it could be a problem with just getting the research done at all. Because right now, the main funders of these kinds of clinical trials are mostly doing the the early stages of these trials that are just meant to see whether the drug is safe. So studies like that will be funded by the National Institutes of Health or the NIH, which tend to fund more like academically grounded research. But beyond that, getting drugs on the market and out to people is usually more of a thing for pharmaceutical companies and venture capitalists to fund. And the challenge with rapamycin is that it’s already been approved by the FDA and it’s already cheap. So it’s not necessarily something that is going to be a huge moneymaker for anyone. So because the NIH at least has not currently funded a lot of this research kind of via the government, we haven’t really seen any pharmaceutical companies step up to try and fund this kind of research because there isn’t really any money in it for them.
Krys Boyd [00:34:21] It’s so funny, you know, the idea that we might actually have this amazing drug that could change billions of lives over the course of time, but because there’s no money in it, people are not that interested.
Celia Ford [00:34:34] Yeah, it’s it’s unfortunately, if you think too hard about the way that research and especially drug development is prioritized and funded, it’ll make your head spin.
Krys Boyd [00:34:46] When you say it’s it’s pretty cheap like cheap we could afford it out of pocket. Do you have any sense of like the cost at a pharmacy of this thing currently.
Celia Ford [00:34:55] So it depends but you can right now buy rapamycin online. Not that I’m saying that one should do this, but like some telehealth companies could offer a low dose of rapamycin for $10 a week, maybe even less. So something that a lot of people probably could afford without the help of insurance.
Krys Boyd [00:35:17] You say you don’t recommend it because it hasn’t been fully tested, like there’s there’s potential for all the things we’re talking about. But but there’s no evidence yet that this is a good idea, Correct?
Celia Ford [00:35:28] Exactly. So I am certainly not a doctor. So I wouldn’t I wouldn’t want to tell anybody to take anything. But yeah, rapamycin’s is anti-aging benefits have not necessarily been proven in human studies, largely as a logistical thing. It’s really hard to prove anything about aging in humans just because of how long we live. So, yeah, its benefits have not been, you know, totally tried and tested. But it does seem that at low doses it is pretty safe. Not too many side effects. If you take it at a smaller dose than you would if you were an organ transplant patient. And at least anecdotally, a lot of longevity researchers that I have spoken to have admitted that they take low doses of rapamycin themselves just in case.
Krys Boyd [00:36:22] Do they did they describe noticing any I mean, I guess you don’t notice yourself aging more slowly because we’re always surprised by the fact that we age at all. But do they do they notice any differences?
Celia Ford [00:36:34] So one person that I spoke to said that he had been struggling with some chronic pain associated with I want to say it was a shoulder injury. And he said that he noticed a difference after taking rapamycin. He suspects that its anti-inflammatory effects were helpful in kind of reducing the chronic pain that he was feeling from an injury. So at least one person told me that they they noticed something happening. But you know, that’s a n equals one. So yeah, probably not a great scientific study on my part. But yeah, it’s hard to tell whether whether you’re aging more slowly or not. I’m not sure how somebody would be able to perceive that themselves.
Krys Boyd [00:37:19] Are these anti-aging researchers who are taking it? Because just in case it works, they want the benefits, are they cognizant of the fact that they might be susceptible to the placebo effect?
Celia Ford [00:37:33] Almost certainly, yes. I think that it it becomes kind of a cost benefit thing where if you’ve weighed the risks yourself and you’ve determined that the the potential benefits, even if they don’t actually come, even if it’s just the placebo effects that you’re feeling, outweigh the potential risks and you can afford to do it. The attitude at least that I heard from a couple of people was like, why not?
Krys Boyd [00:38:01] So the question that struck me is that delaying menopause might sound like a great idea for some people who have menstruated for decades, and it might sound like a terrible idea to others who are ready to be done. Do you think there would be a reluctance? I mean, no one would be forced to take this stuff, but do you think there would be reluctance on the part of people to try this?
Celia Ford [00:38:24] Yeah, I don’t know. I imagine that it would really depend on that individual person’s priorities and what things they cared the most about. Like, I can imagine that if somebody was, say, 40 years old and they really wanted to have a kid in the next 3 to 5 years, then maybe taking a drug that would ward off menopause for a little longer, even if it meant having a monthly period for five more years, that might be worth it. But I can also see how maybe if you don’t want kids and you just want it over with, you don’t want to have to think about your ovaries any more than maybe you would say, bring it on. But I do think that it’s worth noting that periods aside, there are like we already talked about, a lot of things associated with the decline in ovarian function that aren’t just related to whether or not you’re still having your period.
Krys Boyd [00:39:24] In the meantime, assuming most of us I guess you said we can get this online, but most of us probably can’t go to our family physician and ask for a rapamycin prescription and get what we want. Are there other things we can do that science has demonstrated will keep ovaries in prime shape for as long as possible? Or is that just the standard advice to, like, take good care of yourself?
Celia Ford [00:39:46] I think that unfortunately, it’s just the boring advice that everybody is moms has already told them to do. I think it’s mostly just sleeping well, eating a balanced, varied diet and exercising. Exercising is a big one, though, especially for people that are approaching menopause. Because especially doing resistance training can be really beneficial to increasing your bone density and starting to protect against those effects of that upcoming estrogen drop. But yeah, unfortunately, it’s just the same old boring stuff sleeping, moving your body, eating well.
Krys Boyd [00:40:26] It is interesting that we do actually know what works fairly well, but we really want a pill.
Celia Ford [00:40:32] I know it’s because people just like don’t want to lift weights and we want to eat cookies because they’re nice and we want to go to parties and drink alcohol and sleep less. But unfortunately, all of that stuff is good for you. We already know the answers.
Krys Boyd [00:40:48] If you will indulge me in shifting gears here. Celia, you also wrote recently about animal testing and the questions we have around this and when and whether it’s really necessary. Is the thinking changing about the importance of using lab animals for every kind of experiment?
Celia Ford [00:41:06] I think that it is, yeah. It’s just a really hard culture to break out of. But yes, I think that for a long time, animal testing was kind of held up as the gold standard of biological science because it’s hard understanding how a living system works. Like an animal, like a human kind of requires taking it apart and looking at how its insides work. So for a long time, people thought that you couldn’t study things like diseases without looking inside of a fully formed animal, sometimes while it’s still alive. But now we’ve we’re starting to develop a lot more technologies, such like things that we can do on the computer using AI or things that we can do using human derived tissue samples in a petri dish under a microscope that can allow us to study some of the same things that we used to think we could only study in animals without using animals anymore. And now the challenge is going to be to kind of convince the institution of science to start shifting gears away from this model that they’ve been attached to for a lot of decades at this point.
Krys Boyd [00:42:24] Do scientists tend to draw the line, a line between the appropriateness of using animal testing for like medical products as opposed to things like cosmetics or household product?
Celia Ford [00:42:38] I think sometimes is so there there has been a difference in in how these things are regulated and how things like drugs versus things like cosmetics. So cosmetics right now in the United States and a lot of other countries don’t necessarily require that they go through some kind of safety testing in animals first. But up until just last year, anything that counted as a drug, which is more things than you’d think, it’s basically, according to the FDA, anything that claims to alter the structure or function of the body in some way. So that’s anything from rapamycin to like sunscreen had to be tested in animals to demonstrate safety before it could touch the human body, which again, is like theoretically a good thing. We would love to make sure that the products that we’re using and putting inside of our bodies are not going to have horrible side effects that we didn’t think of. But increasingly, we’re able to do a lot of those tests using newer technologies that don’t rely on living animals anymore. And a lot of a lot of labs haven’t really gotten the memo, frankly.
Krys Boyd [00:43:53] Are a lot of scientists conflicted about the ethics around animal testing?
Celia Ford [00:43:59] Yes and no. So I think that I think that in theory, a lot of people would say, of course, we want to minimize the harm that we cause to animals. Of course, we want to make sure that all of the studies that we’re doing are strictly necessary for human safety. But at the same time, a lot of scientists have built their careers around using animals in their labs. They’ve built careers around saying that the only way that they could find something was through the animal models that they’ve developed. And switching gears away from that would kind of require renouncing a lot of their existing work and totally switching over how their research is done, which takes a long time and is really expensive. So unless the government funding agencies that are giving these labs money can help them, can help provide the resources that are required to do this. It’s like it’s not a really easy sell for a scientist to suddenly abandon the models that they know and that they’ve been using for a long time.
Krys Boyd [00:45:06] Celia Ford is a future perfect fellow at Vox, where you can find her article “We have a drug that might delay menopause and help us live longer.” Celia, this has been so interesting. Thank you for making time to talk.
Celia Ford [00:45:18] Thank you so much for having me. This has been fun.
Krys Boyd [00:45:21] Think is distributed by PRX, the Public Radio Exchange. You can find us on Facebook and Instagram. Just search for KERA Think. Subscribe to our podcast for free wherever you get podcasts or listen at our website where you can sign up for our free weekly newsletter. Once again, I’m Krys Boyd. Thanks for listening. Have a great day.
