Choices · women’s longevity and ovarian aging
On our quest, my son Alek and I asked more than a hundred scientists, doctors and healers how to live longer, healthier and more fulfilling lives. Almost a year in, one conversation in Cambridge, with the geneticist Staša Stanković, changed my questions for the rest of the quest. This page is what I learned from her and from the experts I asked afterwards: why the ovaries age faster than the rest of the body, what that means for fertility and for a woman’s whole health, why women were left out of medical research for so long, what science is trying now — and why longevity starts before we are even born. Every number has a source.
By Marek Piotrowski · Updated 2026-10-30
In short
Women’s health is longevity — for a woman, and for the children she may one day have. The ovaries age faster than almost any other part of the body, and their clock matters not only for fertility but for her heart, her bones and her whole healthspan. The hopeful news: after decades in the shadows, science is finally racing to understand it — to tell each woman her own fertility window, and one day perhaps to keep the ovaries young for longer. And a mother’s health before and during pregnancy gives her child a head start for life. [1][2][3]
Longevity, as we mean it: more healthy, joyful years. What we mean →
Before you change anything
This page shares what research and the experts we met say. It is not medical advice, and it does not recommend any medicine, supplement or treatment. It knows nothing about you. Before you start, stop or change anything — especially if you are pregnant, live with a health condition or take any medication — please talk to your doctor. In an emergency, call your local emergency number.
By the summer of 2024, my son Alek and I had been on the road for almost a year. We had met scientists, doctors and healers all over the world, and I thought I knew longevity well. But I had never really put women’s health at the center of my questions. Then Nikolina Lauc, the co-founder of GlycanAge, told me there was someone I simply had to meet: one of the top experts in women’s health, a topic longevity had neglected for years. So in July 2024 I went to the Babraham Institute in Cambridge to meet Staša Stanković, a young geneticist who studies how the ovaries age. Her very first answer stopped me:
“Women’s health was under the veil of taboo for a very long time. There was not much investment around it, not much research happening, and therefore, the basic biological mechanisms behind female reproductive health is not understood. […] Until 1993, women were not part of clinical trials, for example. So that just tells you how the modern medicine was completely shaped around male physiology and anatomy.”
In plain words: For a long time, almost nobody studied how a woman’s reproductive system works and ages. Without that basic knowledge there can be no good tests and no good treatments. And for decades, medicine learned the male body first.
After that day I asked every expert we met about women’s health. Staša became a friend and a warm supporter of our project. I am deeply grateful to her — and to Nikolina, who sent me to her.
Most of our organs age slowly, over many decades. The ovaries are different. A girl is born with all the eggs she will ever have, and no new ones are made later. Staša explained it simply:
“Me, as a girl, I’m born with a finite ovarian reserve in my body. So that number cannot be renewed. It will always be smaller than it is when I was born. So women are born with approximately one to two millions of eggs in their body. And over the time, they will start losing those eggs. And not only that they will start losing them, the eggs that you have in your ovarian reserve will also start declining in their quality, leading to all these problems that we’ve mentioned around fertility and other health outcomes.”
In plain words: Think of a jar of marbles that can never be refilled. Every month some marbles are used up, and the ones left behind slowly lose their shine. That jar is what scientists call the ovarian reserve.
Researchers combined eight studies that counted the eggs in the ovaries of 325 girls and women, from before birth to menopause. For 95% of women, by the age of 30 only about 12% of the most eggs they ever had are left, and by 40 about 3%. The highest number of all comes before birth, at around 20 weeks of pregnancy.
Based on: Model built from eight studies of 325 women [7]Then came the fact that I still repeat to anyone who will listen. I told her that a woman of 35 is a very young woman. She told me that her ovaries, on average, are not young at all:
“In your early 30s, your ovaries are considered geriatric. So the significant decline in ovarian function starts at around age of 35. And that does not only bring problems with the possibility of getting pregnant, but also even if you do get pregnant, that late pregnancy is associated with a number of health outcomes for both baby and the mother. […] And that obviously is based on individuals, so we are all different.”
In plain words: In the early thirties the ovaries are already old in body terms, and from around 35 they lose their function faster. That changes the chances of getting pregnant, and the health of a late pregnancy for mother and baby. But every woman is different: for some it comes much earlier, for others much later.
The American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine say that a woman’s fertility falls gradually but clearly from about the age of 32, and faster after 37. With age, more eggs carry the wrong number of chromosomes, and miscarriages become more common.
Based on: Joint opinion of two medical societies, based on many studies [1]
Staša’s other sentence — that until 1993 women were not part of clinical trials — sounded impossible to me. So I looked at the record.
In 1977, the US Food and Drug Administration (FDA) advised keeping women who could become pregnant out of the first stages of drug trials. In 1986, the US National Institutes of Health (NIH) began encouraging researchers to include women; in 1990, government auditors found that this was poorly communicated and unevenly applied. In 1993, a US law wrote the inclusion of women into the rules for NIH-funded research, and that same year the FDA reversed its 1977 advice.
Based on: Official history and US law [4][5][8]In plain words: For years, the first tests of many new medicines were done mostly on men. That is what Staša meant: medicine learned the male body first, and women’s bodies later.
US government auditors looked at the 10 prescription drugs withdrawn from the US market between January 1997 and January 2001. Eight of them carried greater health risks for women than for men. Four of those may simply have been prescribed to women more often; the other four caused more harm in women even though both sexes used them widely.
Based on: US government audit [6]And it wasn’t only medicine. Brian Kennedy, one of the founding fathers of aging research, told us in Singapore that his own field had overlooked the ovaries too:
“People in the aging field have largely ignored the ovaries, and it’s to our own detriment because it’s one of the fastest aging organs. And we know that when people have menopause, that it causes a lot of downstream aging effects to be accelerated. […] So if we can delay that, I think it will really not only increase fertility, but improve the health of the half of the population.”
In plain words: The ovaries are among the fastest-aging parts of the body, and when they stop working at menopause, aging speeds up elsewhere too. Brian told us his center in Singapore had started a program to find out why — and how to delay it.
This is the part that changed how I see longevity. The ovaries are not only about having children. Staša sees them as an early clock for a woman’s whole body:
“We have to stop thinking about reproductive health and ovarian aging as just something that is related to fertility. I believe that because ovaries age two to five times faster than any other organ in the body, we can use them as a proxy for overall health of a female individual. And not only of the female individual, because we know that menopause timing is very well connected to your longevity and health span, but we can also use it to learn more about aging overall. […] So it seems that this ovarian aging is really an architect or co-architect of overall health span.”
In plain words: Because the ovaries age early and fast, they may show how the rest of a woman’s body will age — like the first leaves that change color in autumn. Learning why they age could teach us about aging for everyone, men included.
A few months later, in Boston, I asked Vittorio Sebastiano, who works on making old cells young again. He is one of the very few top scientists in this field who also works on women’s health, and he has since become a dear friend. He told me the same thing, and his dream:
“There’s a clear connection between ovarian aging and systemic aging in women. The sooner a woman enters in menopause, the shorter the lifespan and the higher the mortality rate and the morbidity associated with that process. Meaning that there are women that enter menopause in their 20s, in their 30s because they have ovarian insufficiency or ovarian failure. […] And so if we could rejuvenate the ovary in those women to begin with, and maybe even in a naturally occurring menopause, if we could give an extra year or two of menopausal age to women, you can have significant impact on the aging process. So that’s my aspirational goal for the future.”
In plain words: When the ovaries stop early — through illness, surgery or nature — the whole body tends to age faster. Vittorio hopes science will one day make the ovaries younger. Even a year or two more of ovarian life could matter for health. Today this is research, not a treatment.
A Dutch study followed 12,134 women for about 17 years. For every year later that a woman’s menopause came, her risk of dying during the study was about 2% lower, and her risk of dying from heart disease was lower too. Women whose menopause came after 55 lived about two years longer than women whose menopause came before 40. Later menopause also came with a slightly higher risk of fatal cancer of the womb or ovaries.
Based on: Study of 12,134 women over 17 years · a link, not proof [2]What menopause itself is, what the hormone studies showed, and how to look after the heart and bones through it, we explain on our page Menopause and longevity: what women should know.
Words worth knowing
From our glossary. Tap a card to turn it over: the science on the back, and the people we met who explained it to us.
Prevention is king: staying well, instead of waiting to be treated.
Prevention
Screening, genomics, imaging and biomarkers catch a problem while it is still small, cheap to treat and yours to decide about. Most health systems are still built for sick care and act when something breaks; longevity turns that into healthcare. Read more →
Level 04 · The Bridge of PreventionHow long you are well.
Healthspan
The years in which you can still do what you love: move freely, think clearly, travel, play with your grandchildren. For most people the gap between lifespan and healthspan is about a decade, and closing it is what most of the field is really working on.
Switches on top of your genes.
Epigenetics
The sequence is fixed; which parts are switched on is not, and that is where lifestyle actually reaches your biology.
Epigenetic age tests have become widely available and remain noisy — useful as a trend over years, not as a single reading. Read more →
It came up most in our conversations with: Eric Verdin, Steve Horvath, Vittorio Sebastiano
After decades in the shadows, women’s reproductive aging is finally becoming a field of its own. Staša’s team studied the DNA of hundreds of thousands of women and found the genes that help decide when menopause comes. She wants to turn that into something every woman can use:
“We currently identified around 300 genes or genetic factors that determine the age when you will go into menopause […] Can we use the knowledge around genetics and around those 300 genetic factors to develop predictive solutions that every woman can take at around maybe puberty to figure out how fertile she will be and until what age? So kind of predict the fertility window. This will be a game changer because as a woman, we don’t have any solution at the moment in the clinic that we can rely on to know when we will go into menopause and therefore plan the fertility journey. So what if I am the candidate of early menopause? I don’t have idea at the moment whether I am or not.”
In plain words: In 2021 Staša and her colleagues reported 290 such places in our DNA. The idea is a test, perhaps in the teenage years, that tells each woman her own likely fertility window — so she can plan her family and her health with real knowledge instead of guessing. When we spoke, no such test existed in the clinic. [3]
Then her team went one step further:
“From those three hundred genes that we discovered, we played with the two genes that we thought would have the nicest effect as a proof of concept. Those are DNA repair genes, so they have a power to repair mistakes in your DNA when they appear. […] What we’ve demonstrated is that when we mimicked the genetic effect of those women, seen in those women in mice, we demonstrated that we can prolong reproductive lifespan and increase fertility by twenty-five percent. So this is one of the first proof of concepts, one of the first evidence that delaying menopause is a possibility.”
In plain words: Two of those genes help cells repair their DNA. When the scientists copied their effect in mice, the mice stayed fertile about 25% longer. These are mice, not women — but it is one of the first signs that menopause might one day be moved. [3]
And she dreams bigger still — carefully:
“I think anything that has to do with artificial womb, in vitro gametogenesis, meaning making artificial eggs, we have to science the hell out of those activities. So we need to ensure that we do a good due diligence that these things are doing what we think they do. […] What I am even more excited about, and that maybe falls a little bit more in what I am doing in my research and the company that we are establishing, is the potential of developing artificial ovaries in the lab. And the reason for that is we will for the very first time have a good model that we can use to study female reproductive biology.”
In plain words: Scientists are learning to grow tiny pieces of ovary-like tissue in the lab, called organoids. They would let researchers study women’s biology on something much closer to a woman’s body than a mouse. Artificial eggs and artificial wombs are further away, and Staša insists they must be tested to the hilt before anyone uses them.
At Columbia University in New York, a study called VIBRANT is testing whether rapamycin — a medicine doctors use to stop the body rejecting a transplanted organ — can slow down ovarian aging. Staša told us rapamycin is one of the most promising ideas so far, and that she is even more excited about what genetics may find beyond it. This is a clinical trial, not a treatment.
Based on: Registered clinical trial [9]
The first person who ever told me this was Tina Woods — a longevity activist, an energy booster with a big smile, whom I first met at a conference in Lisbon three months before our quest began. In Dublin, in the very first days of the quest, she said it on camera:
“Brian Kennedy was just talking about the life course approach, and you have to start even before birth. What your parents do, their lifestyle, the conditions in which they live, the choices that they make, the environments, that shows up later on in the offspring. […] It comes down to having good habits right from the beginning ’cause behavioral change, behavior, is so fundamental in having a good, long, healthy life, and those behaviors, the sooner that you start those healthy behaviors, those habits, the sooner that you start, the better. It doesn’t mean that the game is up if you start later in life. Of course not.”
In plain words: A child’s health is shaped before birth: by the parents’ health, food, stress and surroundings. That is a head start we can give the next generation. And it is never too late to begin good habits yourself.
People conceived during the Dutch Hunger Winter of 1944–45, when food in the Netherlands ran out, were studied about six decades later, each next to a brother or sister of the same sex who was not exposed. Those who met the famine around conception carried different chemical marks on a growth gene called IGF2. Those exposed only late in pregnancy did not.
Based on: Study of 60 people exposed around conception, each compared with a sibling · early science [10]In plain words: What a mother lives through around conception can leave marks on her child’s genes that last a lifetime. Scientists are still learning what those marks mean for health.
Staša told me something that surprised me even more:
“What is really interesting about this as well is, for example, the transgenerational impact of, for example, nutrition on the menopause of your offspring. […] And this is all in mice, so this study was not conducted in humans. But what we’ve observed is that mice who were fed with high sugar, high fat diet, their offspring or their kids had earlier menopause timing than the mice who were fed with a normal diet.”
In plain words: In mice, what a mother eats can even change when her daughters reach menopause. This has not been shown in people. But it fits the picture: the health of one generation reaches into the next.
A baby girl’s ovaries hold the most eggs she will ever have — 6 to 7 million — at about 20 weeks of pregnancy, while she is still inside her mother. So the egg that one day becomes a child was already there when that child’s mother was herself a baby in the womb.
Based on: Joint opinion of two medical societies [1]That idea has stayed with me ever since Tina first said it. It is why I dream of a film just for it: a story about women’s and children’s health, and about the longevity that begins before our first breath.
When I asked Staša what she would tell young women of eighteen about their longevity, she didn’t talk about pills or clinics. She talked about knowledge:
“I think number one message is to work on educating women. These topics, as you can imagine, that touch on female fertility and women’s health have been neglected for a long time. […] When I speak to a lot of women that are not specialists in this topic, they just don’t know how menopause happens, how your ovarian reserve works. They don’t know why they menstruate on a monthly basis. So I think there is a huge gap in the way we understand our own bodies and how we think about fertility. […] So we can’t just be saying, “I’m just gonna do IVF because it’s gonna work.” It’s not. We can’t put all our eggs into one basket. […] So we have to educate ourselves on what’s possible. […] So education, education, education.”
In plain words: Know how your own body works: your cycle, your egg reserve, how fertility changes with age. IVF has helped many families, but it works less well the older the eggs are. Knowing early gives you choices. [1]
She also mentioned blood tests that show how the ovaries are doing right now, such as anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH). It is worth knowing what they can and can’t tell you:
750 women aged 30 to 44, with no history of infertility, had these blood tests when they had just started trying for a baby. Women with low AMH or high FSH were just as likely to get pregnant within 6 or 12 months as women with normal results.
Based on: Study of 750 women · good evidence [11]In plain words: These tests give a rough idea of how many eggs are left. They don’t tell you whether you can get pregnant naturally this year. They are one piece of the picture, to read together with a doctor.
If you are 35 or older and have been trying for a baby for six months, the doctors’ societies advise seeing a specialist then, rather than waiting longer. If your periods stop or become very irregular before 40, see a doctor: an early menopause matters for your long-term health as well as for fertility. And before any fertility treatment, egg freezing or hormone therapy, go through your own history and options with a specialist. [1][2]
Not medical advice, and not a recommendation for or against any fertility test, treatment or medicine. We describe what the studies say and what the scientists told us.
Staša changed my quest. Before Cambridge, longevity in my head was mostly about adding healthy years later in life. After Cambridge I saw that it starts much earlier — in a girl’s teenage years, in a mother’s pregnancy, even inside a grandmother. And I saw half of humanity whose health science had only just begun to study properly. That is not a sad story. It is a beginning. Young scientists like Staša are on a mission, and you can feel it in their smile, their eyes and their focus.
At the end of our talk, half dreaming, I told her what I hope for:
“I hope that we will be living not just for 100 years, but 150 or much more in the future. So at one point I believe we shall find a way how not just help those that have early menopause, but also those that would like to have children at 50 or 60, and then mitigate all the risks and other problems that may emerge from that.”
Until then, the joy is in the simplest things: girls and women who understand their own bodies, parents who give their children a healthy start, and grandmothers who pass on what they know. Longevity is a family story. For Alek and me, it always was.
Every number on this page, by the number in square brackets. Quotations come from Live Beyond’s own recorded interviews, cleaned only of “um” and “uh”. Not medical advice. Talk to your doctor before you change anything.