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The overarching aim of the HoCa study is to understand how loss of ovarian function affects health and well-being. The HoCa study focuses on revealing the effects of oophorectomy, i.e., surgical removal of ovaries resulting in immediate menopause, on quality of life, cardiometabolic health, central nervous system functioning and adipose tissue biology.

HoCa is a multidisciplinary research project that not only investigates the molecular regulatory pathways orchestrating physiological consequences of menopause but also performs qualitative interviews, allowing women’s perspectives, interpretations and feelings about surgically induced menopause to be heard. By combining clinical data with advanced 3D adipose tissue models, HoCa offers a unique human-based approach to studying hormonal regulation, immune function, and metabolic health.

HoCa combines three research components:

• A clinical study with women undergoing surgical menopause (ovary removal).
• A qualitative interview study with a sub-sample of the clinical study participants.
• A laboratory study using 3D adipose tissue models called adipoids, grown from human fat samples.
   

In the clinical study, we follow participants before and after surgery. Because the exact timing of estrogen loss is known, this design allows us to study its effects in a controlled way. We measure body composition, physical performance, central neural system functioning, metabolism, and quality of life. Blood samples are collected to analyze biomarkers such as non-coding RNAs and metabolic compounds related to cardiometabolic health.

At the same time, we develop 3D adipose organoids (adipoids) from fat samples taken during surgery. These organoids are grown from both visceral (deep abdominal) and subcutaneous (under-the-skin) fat. They closely mimic real human fat tissue and contain fat cells, immune cells, and structural cells, making them well-suited for testing how different fat depots respond to hormonal changes.

In lab experiments, these organoids are exposed to blood serum from pre- and postmenopausal women, pure estradiol (E2), or exercise-mimicking compounds such as AICAR or metformin. This allows us to assess changes in adipocyte cell structure, fat metabolism, inflammation, and immune cell composition.

By combining clinical data with organoid experiments, HoCa provides a detailed view of how menopause affects women’s adipose tissue and metabolism, and helps explore whether hormonal or pharmacological treatments can reduce health risks that increase after menopause.

We also interview women before and after the surgeries. This allows us to understand the reasoning process women go through, how they picture the process, who the significant contributors are and how they experience the whole process. it is important to understand how surgically induced menopause is received by women who experience it to be able to offer better, personalised care.