The Study of Women's Health Across the Nation (SWAN) and its seven designated research sites were awarded $44,456,682 over the next five years from the National Institutes of Health (NIH) to investigate how menopause and midlife factors influence cognitive function, bone health, cardiovascular health and overall well-being as women age.
The coordinating center at the University of Pittsburgh and seven sites, including the University of Pittsburgh, Massachusetts General Hospital, the University of Michigan, University of California Davis/Kaiser Permanente, University of California at Los Angeles, Albert Einstein College of Medicine and Rush University Medical Center will conduct complementary studies anchored by those four research areas. The cardiovascular project, led by Rebecca Thurston, associate dean for women’s health research, Distinguished Professor of Psychiatry, and Pittsburgh Foundation Chair of Women's Health and Dementia, University of Pittsburgh School of Medicine, will add neuroimaging to SWAN for the first time in its history of more than 30 years to examine the implications of menopause and its symptoms for women's brain health, cerebrovascular disease and stroke risk later in life, giving a deeper understanding of how connected the heart and mind actually are. Researchers will also use spine X-rays to examine microfractures and bone density as well as test hormone levels, conduct physical functioning testing and explore experiences such as social frailty, loneliness and life purpose.
SWAN is the United States’ largest and most comprehensive longitudinal study of the menopausal transition. In its early years, the study focused on endocrinology and menopause symptoms but has expanded. By following the same women, who are now in their 70s, from different ethnic and racial groups over three decades, researchers can understand the full impact of menopause on women’s overall health.
“Heart attacks, strokes, fractures and cognitive decline often don’t show up until later in life,” says Thurston, one of SWAN’s principal investigators. “By continuing to follow these women over time, we can better understand how menopause shapes long-term health.”
Maria Mori Brooks, professor of epidemiology, Pitt School of Public Health, and principal investigator of the SWAN coordinating center, added that this study aims to understand the biology, psychology and physiology of aging in women.
“Midlife health can affect the ability to carry out daily activities later in life,” Brooks says. “SWAN will continue to collect and analyze complex data from multiple perspectives. Ultimately, it’s a collaborative effort across clinical and scientific disciplines that allow us to answer important questions.” The menopause transition, a normal part of aging that most women experience in their 40s or 50s, is poorly understood. However, SWAN is responsible for the most definitive comprehension of the natural history of menopause, its transition and what it means for women later in life.
“What SWAN can do—more rigorously than any other study—is answer basic questions such as what are the mental and physical changes of menopause and what does it mean if you have an earlier menopause or more persistent symptoms for your long-term health, including your heart, brain and bone health,” says Thurston. “It is absolutely a foundational study when it comes to understanding menopause and its implications for women’s health as they age.”
The continued support of NIH preserves the study’s ability to understand the implications for menopause and its features for women’s later health.