Recognizing the Nuances of Women's Health, From Menopause to Hormonal Health

Nutritional Outlook interviewed Trisha Sugarek MacDonald, market development manager for Akay Bioactives about the importance of addressing menopause in stages (pre-, peri-, and post-menopause) and understanding the impact of hormones on women's overall health, not just fertility, monthly cycles and menopause. These nuances are crucial for developing products that help women address health in more personalized ways instead of using products tested on men and marketed to all women. As MacDonald points out, women going through the same physiological processes like menopause can experience them in vastly different ways, and the products on the shelves meant to help them, do not always deliver the benefits they actually need. The opportunity for innovation and greater scientific advancement is therefore great.

Sebastian Krawiec: To start, I wanted to ask you what you see as the biggest opportunities for innovation in women's health category more broadly and why?

Trisha Sugarek MacDonald: So I think some of the biggest opportunities in women's health that we have today is that as an industry, we are really moving beyond the shrink and pink it formulation and marketing approach that we have used for so many decades. And what this is allowing for us to do as a whole, it's allowing us to move more towards a science based design for creating materials and also designing better products to help meet women's needs, specifically in terms of her biology and health outcomes. And I think that this is really important because for decades, women's health has been really underrepresented in terms of clinical and nutritional research. And because of that, there have been so many gaps in terms of what we've been able to understand about a woman's physiology and about what her needs are across a woman's lifespan and how she's able to navigate major hormonal transitions.

And that gap has really affected everything in how we're able to study her symptoms, but also being able to design products and then being able to help communicate the benefits to her and women, you know, they are their voices are being heard. They are very much now a part of our industry. And there are so many female entrepreneurs. And because of that, we've been able to really hear their voices and their needs and their demands. And now we're able to take all that information and really design products that are going to be clinically substantiated and thoughtfully formulated and designed for their actual biology. And we're not just repackaging general wellness products and saying it's for her. So it's really a huge opportunity to be able to create those science based products that are using plant based solutions or even technologies that are going to help support a woman in a more holistic and personalized and scientific, intentional way.

SK: Menopause is obviously a huge category right now in women's health. Unfortunately, it's, you know, often treated as a sort of a panacea in many cases, women dealing with symptoms that they may not realize it's menopause and kind of dealing with the dealing with the condition in isolation, and without the proper support. So I wonder if you can kind of talk about why it's important to approach menopause in stages, such as pre-, peri-, and post-menopause.

TSM: Absolutely. We do have to be able to look at women's health in terms of those different stages because pre peri and post menopause they are not going to be the same biological experience. And no two women are going to move through those stages in exactly the same way. I think a really good place to start with this is really talking about how hormones are typically referred to as male and female hormones. In reality, they are just human signaling molecules, and they are going to influence almost every major organ system. That's going to be including your brain, your heart, your joints, your bones, the way you sleep at night, how you become more resilient to stress. Because of that, when you have those major hormonal shifts that a woman is going to experience during peri- and post-menopause, but also including during her monthly cycle, a woman is going to feel those changes in a very unique way based on her natural chemistry.

And in terms of that, like you think specifically about perimenopause. This is especially variable because these hormones are not just simply declining in a straight line, right? They are going to be fluctuating significantly because the brain is going to be looking for homeostasis, trying to, you know, continue down the path of having that reproductive impact that the ovarian function is also declining. So, women are going to experience those changes very differently. And that can be in terms of not only their mood, their body composition, their ability to focus, but also temperature regulation. We often hear today that there's maybe about thirty to forty different symptoms specific to peri-menopause and menopause, but the lived experience is so much broader than that. And every woman's biology is going to be unique. Her lifestyle, her stress load, the type of diet that she's going to take. And so that experience that she's going to have is going to be unique to her.

If you actually think about perimenopause and menopause, those transitions, they can last up well up to two decades of her life. So, I mean, that is a very long experience, and the changes that she will have on the front end and the middle and the back end are going to be a very different experience for her. So, because of that, we cannot treat menopause as a single event or one universal symptom set. It is part of a greater continuum. And women, they deserve solutions that are going to evolve with them and reflect the complexity of that, also with their biology.

SK: I wonder if you can kind of elaborate more on kind of hormones and how they influence, you know, our health or women's health beyond monthly cycles, pregnancy and menopause.

TSM: I love that you framed it like that because hormones, all too often we focus solely on fertility cycles, pregnancy and menopause. But again, they are whole body's signaling molecules. Across a woman's life, she has those key hormones. She has estrogen, progesterone, testosterone, luteinizing hormone, follicle stimulating hormone. And they are going to regulate and impact a woman's mood, her ability to sleep, metabolism, appetite, cognition, fertility, but also her long term vitality. Because you have to remember, estrogen is protective in terms of her cognition, her heart, and also her bones. So when these shifts, they do occur. A woman is going to feel it systemically in our twenties and 30s hormones, they are typically going to follow a rhythmic pattern, right? But when we get to our late thirties and our forties, progesterone and testosterone, they start to decline and estrogen becomes much more unpredictable. And that, again, goes back to the brain trying to be able to regulate the body's ability to continue that fertility window. But as the ovarian function starts to decline, you're going to see that impact. And so a woman is going to start noticing those changes in terms of her menstrual cycle, her ability to have a steady mood, her ability to sleep at night, and then having the energy that she needs day to day.

Perimenopause, it has been often coined to be the zone of chaos, where estrogen may spike and drop unpredictably. Luteinizing hormone and follicle stimulating hormone, they continue to rise because they're having to change and adapt with the differences in the ovarian function. But after menopause, those levels of estrogen and progesterone, they plummet. They do stabilize, but at very much lower levels that are typically outside what is considered to be the normal range. And that's where you have a lot of impact to our bones, to our heart, to our brain. And that's why it's so important that when we look at women in terms of vitality, we think of it not just as lifespan, we think about in terms of health span, and we need to be able to view it through that lens that these hormones, it's not just about fertility hot flashes. It's really about being connected to every major organ system of our body so that we can have that vitality. And if we are able to utilize ingredients and products to help maintain those levels within the normal range, we can give women the opportunity to live their best life with confidence and vitality at every stage.

SK: What excites you about the women's health category currently?

TSM: I think what excites me most is that women's health is finally getting its moment in the sunshine. For a long time science and women's health, it was just completely underfunded, undervalued. And because of it, it really turned the women's health category into more of a niche category when it's anything but. And what I love is that women are no longer really accepting these big answers or solutions that are not really built around their biology or even their lived experience. They're demanding more, as they should. And an example of this is what I also see in terms of science. The Women's Health Initiative that was done many years ago that looked at hormone replacement therap; it really shaped decades of fear and confusion. And while that research was important, the conclusions that were broadcasted, they did so in a way that didn't really fully account for age, for timing, for formulation, or even individual risk. And the result is that many women suffered in silence and were left without appropriate support or care during one of the most major life transitions that they will ever experience.

And while some have said it may be considered the crime of the century, what gets me excited today is that we are now correcting course, and we're asking better questions, and we're designing better research, and we're recognizing that women's health deserves solutions that will help them live their best life, helping them to live longer and better. And again, not just focusing on lifespan, but addressing health span. And women already tend to outlive men, but often so they do so in those later years with reduced quality of life. And that's not good enough. Women are demanding better, as they should. So in terms of the nutraceutical perspective, this really creates this powerful opportunity to support women with clinically substantiated, evidence backed solutions that are going to help them address each one of their different life stages, and also the symptoms that they are experiencing, so that they are going to have those meaningful design products that are going to help their voices be heard, help them to feel more confident, and also be more vital throughout every stage of their life.