Using genetics to understand the role of hormones in postmenopausal health

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The health of older women poses significant challenges for future healthcare. Due to longer life-expectancy, women are living for longer after menopause and many will have multiple health conditions as they age, but historically women's health research has been underfunded. Rates of disease increase rapidly after menopause, which is marked by substantial hormonal changes and life-changing symptoms for many women. We have limited understanding of the impact of hormonal changes across life on health after menopause. HEALTH-PM will use state-of-the-art genetic epidemiology to test causal relationships of hormones with postmenopausal diseases and conditions, including menopausal symptoms. I will increase the size of existing genetic studies of hormones up to 10-fold through novel analyses of primary care health records linked to genetic data in 230K people, addressing the complexity of such data. For the first time, widespread genome-wide analyses of postmenopausal disease will be performed, by combining health records data from hospitals, primary care and cancer registry with self-reported menopause status. The objectives of HEALTH-PM are to: 1. Characterise the relative importance of amounts of hormones, duration of exposure or changes in levels for postmenopausal health. 2. Identify a beneficial sex hormone profile over life for good postmenopausal health. 3. Determine whether postmenopausal diseases in women are impacted by hormone changes around menopause over and above the consequences of ageing. 4. Quantify the effects on population health of intervening with hormone treatments. I am uniquely positioned to deliver HEALTH-PM given my expertise in complex trait genetics and health data, becoming a leader of this emerging interdisciplinary field as further large-scale linked genetics and health data are released. Given the possibility for modifying hormone levels with existing therapies, HEALTH-PM offers the potential to substantially improve women's health.