InsideTracker is rolling out more in-depth, personalized health insights for women across the lifespan.
Hormonal changes and the common use of exogenous hormones shape the stages of a woman’s lifespan: the reproductive years, perimenopause, and postmenopause. While these life stages aren’t considered conditions or diseases, they are accompanied by a wide range of symptoms and health concerns that influence decisions about care and treatment that are specific to the female sex. In addition, research is now uncovering multiple conditions and diseases with sex-based differences in their presentation and effective therapies, which have previously been masked by decades of underrepresentation of women—especially women of color—in clinical research.
InsideTracker is dedicated to providing personalized health analytics that informs data-driven guidance, and we are proud to announce the expansion of insights that are now and soon to be available to our female customers as it relates to their menstrual cycle, birth control method, hormone replacement therapy, and menopausal status.
Our promise for a renewed emphasis on women’s health
“We will provide support for [women] through science-backed recommendations that apply to whatever stage of life they are in—before, during, or after menopause—and we are actively looking into additional biomarkers to complement our current offerings to provide a more complete picture of their health,” says InsideTracker’s VP of Science and Artificial Intelligence Dr. Renee Deehan.
Personalization has always been the core of InsideTracker. Our scientists have accounted for sex differences when creating optimal zones for the 48 biomarkers measured, the scientific intel on factors that could be influencing biomarker levels, and within recommendations. But now, we’re taking it a step further.
“Sex and gender inequity in healthcare is real, and we are committed to doing what we can to close that gap,” says Dr. Deehan. “For example, women have a higher chance of dying from heart failure compared to men because they can present with different symptoms. We want to arm [women] with the knowledge and education needed to understand their own unique biology.” [1]
This project started with the science team completing a review of the existing scientific literature on the relevant topics and ranking the quality of the evidence. “This helps us summarize the relationships that are evidence-based,” says the project’s lead scientist, Molly Murphy, MPH, RD, LDN. “Reviews included the topics of menopause, hormone use (via menopause hormone therapy and hormonal contraceptives), and their relationship to biomarkers and physiomarkers, as well as recommendations for optimizing markers specific to these populations.”
The majority of the studies analyzed and that are currently published on women’s health topics have study populations that include people with ovaries and who have identified as a woman. More medical and health data is needed in this area to improve inclusivity for all women in women’s health initiatives. It’s important to note where the scientific literature stands today.
Installments of this women’s health initiative focus on the physiological uniqueness of women throughout their lifespan, specifically the premenopausal, perimenopausal, and postmenopausal relationships with health and longevity.
And the first addition of this initiative has just been released. “We started by taking a deep dive into the literature about menopause and peri-menopause, in part, because those phases are pretty much never talked about until you’re in them,” says Dr. Deehan.
InsideTracker female customers who are peri- and postmenopausal can now see…
- Personalized explanation of biomarker and physiomarker changes related to menopause
- New recommendations to improve or mitigate menopause-related changes
- Relevant updates to existing recommendations that have menopause-specific information
- New personalized ProTips
“Next we are tackling pre-menopause and hormone therapy-related insights,” says Dr. Deehan. “In a future state, we hope to provide our users with gender and sex-specific insights that we learned from our own population; add more hormone biomarkers to deepen our ability to assess an individual’s biological state; and provide specific recommendations for individuals undergoing gender-affirming therapies or are intersex.”
You can expect similar insights into other life stages as well as insights based on exogenous hormone use to soon follow.
Who will see these insights?
The sex-based insights at InsideTracker are determined by biological sex. During the customer onboarding process, you are asked to select your biological sex from one of two options: male or female. This information is used to funnel the correct lab slip for the blood draw, and it influences the optimal zones, recommendations, and insights that a person receives. If you use Gender Affirming Hormone Therapy, select the option that aligns with your therapy. You then have the option to select your gender identity.
The women’s health insights at InsideTracker apply to everyone who selects the biological sex of female at onboarding, and the insights are further personalized via the selection of pre, peri-, or postmenopausal status. And insights will be relevant for those who have a natural menstrual cycle, use hormonal or non-hormonal contraceptives, or are undergoing menopausal hormone replacement therapy.
However, these insights are not encompassing for pregnancy, and we still recommend pregnant and breastfeeding women wait to get an InsideTracker blood analysis until seven months postpartum or two to three months post-breastfeeding.
Understanding women's life stages
Let’s dive more into each of the life stages this initiative is equipped to provide guidance on.
Reproductive years
A woman’s reproductive years are characterized by the presence of a menstrual cycle, a 28-day cycle consisting of four phases that lead to natural fluctuations in hormone levels. Puberty marks the onset of these years and can last until around 49 years of age. [2] Use of contraceptives during this time is quite prevalent. For example, it’s estimated that 16% of women of reproductive age in the United States take a birth control pill, 6.4% have an intrauterine device, 2.8% get an injectable, and 1.2% use a vaginal ring. [3,4]
“We also know that the use of exogenous hormones for contraception like pills, patches, IUDs, implants, and so on, impact the body’s hormonal metabolism and can change biomarker status,” says Molly. And InsideTracker’s user database also shows differences in hormonal contraceptive use and certain biomarker levels. “For this population, the focus of the initiative is on interpreting biomarker levels in the context of these hormonal influences and providing recommendations that support optimized levels for whichever contraceptive status a woman may have,” she notes.
InsideTracker does not advise on whether or not someone should start or discontinue contraceptive use, and please consult with your physician if you have questions.
Perimenopause
Perimenopause means around menopause and is a time of significant changes in the patterns of a woman’s menstrual cycle. Hormonal levels, especially estrogen, fluctuate and then begin to drop, which can trigger symptoms like irregular periods, mood changes, sleep, and overall wellbeing. In fact, it’s estimated that 80% of women in the menopause transition experience one or more symptoms like hot flashes, depressed mood, or sleep disruption. [5, 6] The severity or inconvenience of these symptoms may prompt up to 60% of women to visit a healthcare provider, according to survey data. [7] Women enter perimenopause at different ages, and the overall length of this stage can vary.
“Recommendations for the perimenopausal population are focused on diet and lifestyle changes that can minimize the negative effects of this time of transition and help optimize sleep, stress, and related biomarkers,” says Molly.
The perimenopausal stage officially concludes after one year (12 consecutive months) has passed without a menstrual period, which marks the day of menopause.
Postmenopause
That’s right. Menopause is technically just that one day of a woman’s life. Postmenopause refers to the time after the end of menstruation. Most women can spend more than one-third of their lives in this post-menopausal stage, as they are around the age of 51 when they reach it.
Estrogen and other sex hormone levels stay consistently lower in this stage compared to the reproductive years.
“Changes that are normally thought of as simply being age-related can be associated with the hormonal shift of menopause as well as chronological aging,” says Molly. “A woman’s risk of various chronic diseases increases with age in correspondence with the menopausal transition.”
Chronic conditions that become more prevalent in the postmenopausal period include: [7]
- Metabolic syndrome (high blood glucose, high triglycerides, low high-density lipoprotein, and excess abdominal fat.
- Type 2 diabetes
- Cardiovascular disease
- Some cancers (like breast cancer)
- Cognitive decline
And currently, some of the most notable prevention tactics for these conditions are lifestyle related. [8] So the question many women seek to answer is, how can I live the rest of my life to the fullest?
InsideTracker’s peri- and postmenopausal insights provide some of the intel and guidance on evidenced-based solutions this group of women has been looking for. Not only will people see what blood biomarker changes may be, at least partially, attributed to menopausal changes, but they get personalized recommendations that
- Support menopausal symptom reduction
- Promote optimal biomarker levels related to potentially at-risk areas of health: metabolic health, heart health, and cognition
“Bone mineral density changes, sleep disturbances, cardiovascular health risks, and changes in functional fitness are all targets of recommendations to optimize healthspan in postmenopausal women,” says Molly.
What’s on the horizon for women’s health at InsideTracker?
This is just a start to the women’s health offerings at InsideTracker. “This is something that has been on our radar for a while, and including insights and recommendations specific to women and their life phases is just the first step toward our goal of expanding personalization across the spectrum of our users’ demographics,” says Molly.
Dr. Deehan believes that knowledge is power and she’s excited about the potential “to answer [the] many excellent questions we have received from our users about their own health and experiences. For example, Are there any supplements that may help with hot flashes? What is the impact of my cycle phase on exercise and recovery? How can I maintain muscle mass and strong bones as I age?”
The first updates of the initiative are currently available for peri- and postmenopausal women, soon to be followed by updates for women in their reproductive years, and women using hormonal treatments.
“InsideTracker is all about personalization, and I’m excited that we’re factoring in how much female physiology lends to the individual health of the women using our product,” Molly notes. “Women are being included in research more and more of late, and we’re hoping to reflect the most up-to-date and relevant information that wasn’t necessarily available to women before.”
References:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167225/
[3] https://www.cdc.gov/nchs/fastats/contraceptive.htm
[5] https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110996
[6] https://pubmed.ncbi.nlm.nih.gov/18074100/
[7] https://pubmed.ncbi.nlm.nih.gov/17964093/
[8] https://pubmed.ncbi.nlm.nih.gov/24969415/
