new research on menopause

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Menopause articles from across Nature Portfolio

Menopause is the permanent cessation of menstrual cycles. Natural menopause is caused by ageing-related loss of ovarian function; by contrast, iatrogenic menopause occurs due to medical interventions such as removal of the ovaries. Menopause can cause symptoms such as hot flushes and it increases the risk for certain diseases such as osteoporosis.

Latest Research and Reviews

Early menopause is associated with abnormal diastolic function and poor clinical outcomes in women with suspected angina

• Seong-Mi Park
• Wan-Joo Shim

The impact of reproductive factors on the metabolic profile of females from menarche to menopause

Here, the authors explore the relation between age at menarche, parity and age at natural menopause with 249 metabolic traits in over 65,000 UK Biobank to explore whether reproductive factors are likely to impact females’ metabolic profile later in life.

• Gemma L. Clayton
• Maria Carolina Borges
• Deborah A. Lawlor

FSH and ApoE4 contribute to Alzheimer’s disease-like pathogenesis via C/EBPβ/δ-secretase in female mice

Follicle stimulating hormone (FSH) has been shown to Alzheimer’s disease like pathology in rodent models. Here the authors show using cellular and animal models that ApoE4 and FSH collectively act to trigger AD-like pathogenesis, by activating C/EBPβ/δ-secretase signalling.

• Seong Su Kang

Non-invasive biomechanical assessment of the prolapsed vaginal wall: an explorative pilot study on cutometry and indentometry

• Yani P. Latul
• Arnoud W. Kastelein
• Jan-Paul W. R. Roovers

Sex and menopause impact 31 P-Magnetic Resonance Spectroscopy brain mitochondrial function in association with 11 C-PiB PET amyloid-beta load

• Steven Jett
• Jonathan P. Dyke
• Lisa Mosconi

Menopause induces changes to the stratum corneum ceramide profile, which are prevented by hormone replacement therapy

• Alexandra C. Kendall
• Suzanne M. Pilkington
• Anna Nicolaou

News and Comment

Comparative study in toothed whales sheds light on menopause evolution

• Anna Kriebs

Menopause influences tau pathology

• Heather Wood

Dissecting the genetics of ovarian ageing

A new study in Nature reports a large-scale genome-wide association study of menopause timing, revealing mechanistic details and potential therapeutic opportunities for preserving human fertility.

• Darren J. Burgess

Genetic control of menopause

Myriad genetic and biological factors control the timing of menopause—understanding these has implications for fertility and health.

• Karen O’Leary

Don't be so quick to stop hormone-replacement therapy

Finnish women <60 years old have an increased risk of death from cardiac events or stroke within a year of stopping hormone-replacement therapy (HRT), compared with women who have not had HRT and with those on current therapy. The safety of the practice of annual discontinuation of HRT should be questioned.

• Rogerio Lobo

Perimenopause and menopause as oestrogen deficiency while ignoring progesterone

• Jerilynn C. Prior

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Menopause Is Finally Going Mainstream

K athryn Clancy wrote an entire book about menstrual cycles. But even she was surprised by some of the pre-menopausal symptoms she recently began to experience at age 44.

“A lot of things that have to do with my uterus, ovaries, and breasts, I have been massively underprepared for as a Ph.D.-level expert in this field,” says Clancy, a professor at the University of Illinois Urbana-Champaign. “That should tell you how even more underprepared most people are.”

Most people who menstruate will experience symptoms including hot flashes, brain fog, and changes to mood, sleep, and sexual function as they approach menopause, defined as the point in time a year after their last period. But that transition, which typically begins between the ages of 45 and 55, is so rarely discussed in society —and at the doctor’s office—that people often know nearly nothing about it in advance. One 2023 study of post-menopausal women found that almost none of them had learned about menopause in school, and about half of them “did not feel informed at all” about the life stage.

But there are signs that menopause is finally going mainstream, as both the medical and business worlds get serious about the needs of the million-plus people in the U.S. who reach menopause every year. The U.S. Food and Drug Administration (FDA) in 2023 approved Astellas Pharma’s drug to treat menopausal hot flashes, and pharmaceutical giant Bayer is currently developing a similar medication . Some companies are beginning to offer menopause benefits to their employees . Lawmakers have pushed for more research on menopause. And a flurry of menopause-focused startups have launched in recent years to supplement traditional care, since studies suggest a significant portion of people going through menopause are not treated . The company Alloy , for example, connects patients to menopause specialists via telehealth and sells wellness products targeted toward those going through the transition.

“I have really noticed, thankfully, a new attention and interest in taking care of people during this transition,” says Dr. Ghazaleh Moayedi, a Texas-based ob-gyn who provides menopause care. She attributes that shift to growing numbers of women holding positions of power in business, tech, and medicine, and to social media’s ability to spread information among patients.

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But fixing the problem will take more than well-branded startups, or even new FDA-approved therapies, which not all patients are able to get. Experts believe a meaningful shift will only take place once the core issues change: how research is conducted and disseminated, how doctors are trained, and how seriously practitioners take women’s pain.

For Dr. Sharon Malone, chief medical advisor to Alloy, the medical system’s problems with menopause go back to 2002. That’s when a major study was published, linking hormone therapy —which can ease menopause symptoms by boosting levels of hormones that have dropped off—to increased risks of breast cancer and other serious conditions. After that, hormone therapy use plummeted in the U.S .

But, Malone says, there’s a crucial caveat to the data: the study participants' average age was 63, older than that of a typical patient receiving hormone therapy for menopause. Later analyses , and statements from researchers involved in the study , clarified that the risk of breast cancer may have been overstated, particularly for younger people.

In a 2022 position statement , the North American Menopause Society said hormone therapy has more benefits than risks for women younger than 60 and within 10 years of menopause, unless they have specific complicating health factors. But many doctors and health groups remain wary. The U.S. Centers for Disease Control and Prevention, for example, still cautions that hormone therapy may be associated with higher risks of breast cancer when taken for at least five years.

There has also been debate about whether hormone therapy is linked to a heightened risk of dementia—a risk that Dr. Kejal Kantarci, a professor of radiology at the Mayo Clinic, says her research has not borne out, at least among younger people. In a 2018 study , Kantarci and her colleagues compared a small group of women who used menopausal hormone therapy in their 40s and 50s with those who took a placebo. Three years later, they found no significant differences in cognitive function between the two groups. Other studies, however, have reached different conclusions .

The result of all this back-and-forth, Malone says, is that “we are now looking at a generation of doctors that really have not had formal or informal training in how to treat menopause. Women don’t know what to expect, and doctors don’t really know what to do.”

Moayedi says the problems in physician training go deeper than hormone therapy. “I don’t remember a single lecture from medical school about menopause,” she says. And after graduation, she, like many of her colleagues, worked in a clinic staffed by doctors finishing their medical training, which mostly served people who were uninsured or underinsured. Most of the patients Moayedi saw were lower-income pregnant people who qualified for Medicaid or older people on Medicare—which meant she hardly ever saw people who were going through menopause, despite training to become an ob-gyn.

Physicians who don’t specialize in obstetrics and gynecology likely know even less, she says, because women’s health is often (wrongly) considered “separate from the rest of medicine.” Moayedi says she often sees patients who have been misdiagnosed with other conditions, including ADHD , because their primary care doctor didn’t realize that symptoms like brain fog can be linked to menopause.

Another reason doctors are under-informed, Clancy says, is that most reproductive-science research looks at people at the peak of their childbearing years, which typically excludes adolescents and adults entering menopause. She says there’s a clear need for more studies—and more funding for studies—on people who fall outside those main reproductive years. A bill introduced in 2022 called for $100 million for menopause research in 2023 and 2024, but it hasn’t moved forward.

Even so, Malone says she’s encouraged by the fact that menopause is receiving renewed attention—and that people are noticing the need for that course correction at all.

“Women of a certain generation just assumed that suffering was just part of being a woman, our unfortunate lot in life,” she says. Now, she says, patients “are saying, ‘This is nonsense. You’re going to have to do better by us.’”

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The lifeflight legacy: 40 years in 40 photos, february 23, 2023, study sheds new light on hormone therapy as menopause treatment.

Vanderbilt research shows that hormone replacement therapy can be safely administered depending on the method used and the patient’s age, time since menopause, and risk of cardiovascular disease.

Hormone replacement therapy (HT) was widely used to treat menopause symptoms as recently as 20 years ago, but its use declined significantly in the last two decades because research showed it increased cardiovascular risks.

However, much has been learned since, showing that HT can be safely administered depending on the method used and the patient’s age, time since menopause, and risk of cardiovascular disease.

Those are the findings of a new review of medical literature just published in the journal Circulation , “Rethinking Menopausal Hormone Therapy: For Whom, What, When and How Long? ,” from senior author Kathryn Lindley, MD, director of the Women’s Heart Center at VUMC. Lindley said HT can make a big difference in women’s quality of life; many have benefited from it, and many more could be good candidates who haven’t been considered.

“I think this paper is going to be a real resource for cardiologists,” said Lindley, associate professor of Medicine. “We wrote this manuscript with the cardiologist in mind to help them frame how to use and how to assess hormone replacement therapy for their patients. This paper brings in experts from cardiology, menopausal health, GYN and endocrinology to integrate information and determine a middle ground for approaching menopause.”

About 6,000 women in the nation enter menopause each day at a mean age of 52, the paper states, with common symptoms including hot flashes and night sweats, and are associated with anxiety, disrupted sleep and reduced quality of life. HT has proven effective in addressing those symptoms and became an increasingly popular therapy from the 1960s through the 1990s — topping out at 90 million HT prescriptions per year.

That plunged to about 20 million yearly HT prescriptions today after seminal primary and secondary prevention trials that showed an excess cardiovascular risk with combined estrogen-progestin.

Lindley’s review found that women with established cardiovascular risk — such as stroke or heart attack — should not receive HT, but those with low to moderate risk should be considered.

Generally, women are considered low risk if they are younger than 60 or within 10 years of the onset of menopause without cardiovascular risk factors such as high blood pressure, diabetes or obesity. Even women with moderate risk could be considered for HT, with appropriate cardiovascular monitoring, because the risks are low, and the quality-of-life benefits could be significant, Lindley said.

Lindley encourages women to consult their primary care physicians, OB-GYNs and cardiologists on the onset of menopause or, preferably, before. If they haven’t already, it is a good time to get a thorough cardiovascular evaluation to better understand their risk of cardiovascular disease and their individual risk of HT use.

“That is a time where we really need to be monitoring their weight, blood pressure, cholesterol and blood sugar so that we can identify changes in those risk factors and treat them very promptly,” Lindley said.

Lindley said the paper suggests an opportunity to better study the use of hormone replacement therapy in patients with cardiovascular risk factors, as the earlier seminal studies are now decades old.

“We really need to look at what symptoms the patients are having, what their overall risk is, and consider the tools available to us to safely provide them with some symptomatic relief,” she said.

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