Ovarian transplant pitch demonises menopause

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Recent headlines in The Guardian proclaimed that 'a new medical procedure could delay menopause by 20 years'. The procedure involves surgically removing ovarian tissue from a woman while she is young and preserving it cryogenically. When the woman is older, the tissue can be surgically re-implanted. Consequently, the young and revived tissue will produce and release the hormones necessary to delay menopause.

Smiling woman (Getty Creative)This procedure has been routinely used for about two decades for girls and young women undergoing cancer treatment that may render them infertile, giving them the prospect of having children where their cancer would otherwise have precluded it. The difference in this latest announcement is that the procedure is being applied to otherwise healthy women. 

In fact, its vendors (and I use the term advisedly) are spruiking its health benefits for women. The procedure will apparently alleviate serious health complaints such as heart conditions and osteoporosis that are linked to menopause. But it can also delay common symptoms of menopause such as hot flushes, low mood, and anxiety. The treatment would, according to its promoters, save the national health budget by reducing treatment costs associated with menopause-related conditions and symptoms.

Additionally, as an expansion of the original purpose of the procedure, women could extend their fertile years if they have delayed having children to suit career or other life plans.

As with most advances in medical technologies and procedures, there is always a good story to be told. Giving women control over their fertility where it has been impaired due to serious illness is a wonderful achievement.

However, in focusing on the 'benefits' of delaying menopause, the promoters' description of the procedure presents menopause as a necessarily detrimental condition. Consequently, ovarian cell transplantation is sold as a prophylactic against disease and symptoms that may not even occur or that may have minimal effect on the woman involved.

Notably, the procedure is being sold by its promoters — an IVF company — at the hefty price of between £7000 and £11,000. So, while the 'discovery' is possibly newsworthy, the story must be read as a sales pitch. Maybe the 'benefit' for the national health budget is arguable — but if the health budget were to underwrite the cost of the procedure, then the company marketing it would certainly stand to benefit. There are few qualms about the procedure's originally intended purpose, but the new application barely stands up to scrutiny.

 

"Instead of 'curing' menopause, we should instead continue to overturn negative attitudes to women and to ageing."

 

Every woman experiences menopause differently and some suffer with symptoms more than others. However, there is evidence that 'social attitudes and perceptions of [menopause] can impact its severity'. Concerningly, in focusing on menopause as harmful, the pitch for the procedure only reinforces negative perceptions — especially among younger women. This alone creates its own detriment, even for women who do not take up the procedure.

Additionally, because all women experience symptoms differently, there is no way to tell in advance whether a woman will be likely to need any 'treatment' when she reaches menopause. But the ovarian transplant procedure requires her to undergo surgery up to decades in advance of her menopause — with no guarantee that the procedure is warranted, and no guarantee of success or likely endurance of its effect. In other words, the procedure is speculative.

Finally, ovarian tissue transplant appears to be an additional tool in the armoury of fertility treatments. IVF treatment already extends women's fertility but may be refused to an older woman. The new treatment would apparently make it more likely that a woman could become pregnant naturally without the need for IVF treatment. This opens up a new market for the vendor company — treatment of women who may not have previously needed its services. 

But additionally, it normalises delayed motherhood without seeking to address the structural reasons for delaying fertility. Financial pressures, and the pressure of education and career advancement while young, are leading causes of women's decisions to defer having children. Rather than pushing for an exhausting lifetime of fertility, we need education and career paths that accommodate procreation during women's (naturally) fertile years. And we need financial levers that are responsive to women's life paths. Such changes would generate true reproductive freedom.

And this brings us to the other key objection to the selling of this new procedure. As a society we have tended to ignore ageing women, and menopause has been read as a signal of our descent into decrepitude. The sales pitch — avoiding all the harms of menopause and staying young for another two decades — buys into this outdated way of thinking.

For many women menopause is not a burden, but instead brings benefits — in particular, no more menstruation, no more pregnancy, and new purpose in life. Although in the past women bore 'the change' silently, we are becoming more open about discussing menopause publicly. This has coincided with increasing availability of hormone replacement therapy as a safe and effective treatment for troublesome symptoms. As menopausal women are more likely to continue working, even workplaces are starting to understand that they need to, and can, accommodate mature women in the workforce as their bodies change. 

For all those who experience difficult symptoms, menopause remains overall a positive part of women's lives — which makes the pitch for ovarian transplant seem particularly out of touch. Instead of 'curing' menopause, we should instead continue to overturn negative attitudes to women and to ageing. In particular we need to question the need to medicalise women's bodily processes where it is not called for.

 

 

Kate GallowayKate Galloway is a legal academic with an interest in social justice.

Main image credit: Getty Creative

Topic tags: Kate Galloway, menopause, women's health

 

 

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Existing comments

Yet another example of using medical innovation designed to treat disease in a perfectly normal, healthy human being for no purpose other than to make money for a business man with a medical degree who has no respect for his fellow human beings, his "profession" or the Hippocratic Oath.
john frawley | 14 August 2019


I find this sales pitch most perplexing. I can't think there'll be too many people taking it up. And I agree that it portrays menopause as something awful, which is the complete opposite of my experience. Menopause was among the most liberating events in my life. I only wish it had come sooner.
MsM | 14 August 2019


Well expressed Kate, thank you for setting out all the issues women face at this important time in their lives. As a male I can not relate to the heath and mental issues facing women undergoing menopause. My wife went through it relatively early, in her forties .She was very fortunate as her symptoms were minor. She enjoys a healthy, productive post menopausal life since the transition, without need for hormone replacement therapy. The promoter of this procedure ignores the moral and ethical issues associated with this grave misuse of medical practice. It should be banned for non medical uses.
Gavin A. O'Brien | 15 August 2019


Yet again,some people are trying to demoralise older women and present menopause as a condition to be eliminated not a natural part of life. Some women suffer quite severe symptoms which require medication but others, like me, just have increasingly longer cycles until menstruation ends. There may be no adverse effects requiring HRT but it seems now the menopause is written of as an illness with terrible side effects ,hot flushes, fatigue, and loss of libido .Combined with greying hair, thickening waist, and wrinkles ,this is presented as a dreadful symptom of ageing not just a natural stage of a woman's life.
Mary Samara-Wickrama | 18 August 2019


Apparently, medicalisation is OK if its purpose is contraceptive. Having accepted the principle that medicalisation is permissible in support of choice, what’s the problem with medicalisation in support of the choice to remain open longer to new life? As for what is true reproductive freedom, following the principle of choice, it must mean allowing a woman the freest access to technology to combine the time-monopolising characteristic of full-time paid work, in maximal satisfaction of a sense of economic autonomy, with the equally time-monopolising characteristic of full-time mothering in maximal satisfaction of a sense of emotional purpose.
roy chen yee | 24 August 2019


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