Special Report: Future research outlook

In the final episode of the Contemporary OB/GYN Special Report series, JoAnn V. Pinkerton, MD, and Jill Liss, MD, MSCP, FACOG, reflected on emerging areas of menopause research and the future of personalized medicine in managing vasomotor symptoms (VMS) and related health concerns.

Pinkerton emphasized the potential for more individualized treatment approaches. “We’re going to have personalized medicine, personalized treatment, figuring out how to target the most bothersome symptoms or the health risks,” she said. She highlighted several key areas of ongoing investigation, including the safety of lower-dose transdermal and micronized progesterone hormone therapies,¹ the cardiovascular and cognitive effects of both estrogen decline and VMS, and the long-term risks and benefits of extending ovarian life. Pinkerton also called for further study into how probiotics, dietary interventions, and the microbiome may influence menopause symptoms and overall health.

Liss agreed that personalization and data integration represent the next frontier in menopause care. “Catching menopause up by answering all these questions and becoming aligned with the future of digital symptom tracking and personalized medicine is really exciting,” she said. She noted that much of current clinical practice remains trial and error, emphasizing the need for tools that better predict individual treatment response and safety.

The discussion also explored weight management, mood, and cognition as underrecognized research priorities. Pinkerton pointed to the need for more evidence on metabolic changes during menopause and how treatments such as hormone therapy or newer agents might influence insulin resistance and weight gain.² Liss added that improving sleep, reducing hot flashes, and optimizing symptom control could have downstream benefits for mood and cognitive function.

Both experts concluded that addressing these unanswered questions will be essential to advancing menopause care. “Why does estrogen seem to help the brain when you’re close to menopause and accelerate cognitive changes when you’re older?” Pinkerton asked. “The same thing goes for the heart—those are 2 big unanswered questions.”

Our Experts:
JoAnn V. Pinkerton, MD, division director, Midlife Health Center, University of Virginia.

Jill Liss, MD, MSCP, FACOG, associate clinical professor of Obstetrics and Gynecology, University of Colorado School of Medicine.

Liss has no relevant disclosures to report. Relevant disclosures for Pinkerton include Bayer.

References:

1. Newson LR, Lass A. Effectiveness of transdermal oestradiol and natural micronised progesterone for menopausal symptoms. Br J Gen Pract. 2018;68(675):499-500. doi:10.3399/bjgp18X699353
2. Lovre D, Lindsey SH, Mauvais-Jarvis F. Effect of menopausal hormone therapy on components of the metabolic syndrome. Ther Adv Cardiovasc Dis. Published online May 27, 2016. doi:10.1177/1753944716649358