Study finds menopause marks abrupt physiological shift across multiple body systems

A Nature Medicine study led by Uri Alon analyzed 300 million tests from over 1 million women, reporting that menopause triggers abrupt, cliff-like biological shifts across 52 of 90 lab measures, with hormone changes beginning up to 15 years prior. However, independent Australian medical experts Martha Hickey and Elina Safro pushed back, describing the cliff characterization as unnecessarily alarming and scientifically unconvincing.

Overview and findings of the menopause study

• ▪The Nature Medicine menopause study detected statistically significant abrupt step-like changes in 52 of 90 analyzed laboratory tests following the final menstrual period.
• ▪The Nature Medicine study identified post-menopause physiological shifts across sex hormones, bone health, liver function, kidney function, blood chemistry, and blood fats.
• ▪A study published in Nature Medicine on October 12, 2026, led by Uri Alon of the Weizmann Institute of Science, found that menopause is characterized by abrupt, step-like physiological changes across body systems.
• ▪The Nature Medicine study revealed that step-like biological changes observed around menopause in female individuals were absent in age-matched male control cohorts.

Data and methodology used in the study

• ▪Researchers analyzed two large datasets totaling more than 300 million laboratory tests from over 1 million women in the United States and Israel between 1999 and 2024.
• ▪The Nature Medicine study applied a computational deconvolution framework adapted from astronomy to reconstruct trajectories aligned to the estimated age of the final menstrual period.

Hormone trajectory changes prior to menopause

• ▪The Nature Medicine study found that anti-Müllerian hormone levels began an accelerated decline approximately 15 years prior to the final menstrual period.
• ▪The Nature Medicine study found that follicle-stimulating hormone began an accelerated rise 14 years before menopause, while estradiol began an accelerated decline 12 years before menopause.

Menopausal hormone therapy

• ▪The Nature Medicine study indicated that menopausal hormone therapy was associated with reduced physiological changes after menopause, particularly regarding bone, liver, and kidney function.
• ▪Uri Alon stated that the Nature Medicine study suggests taking menopausal hormone therapy earlier could help maintain bone health.

Criticisms of the study methodology and conclusions

• ▪Martha Hickey, head of menopause services at The Women's Hospital Victoria, described the study's claim of cliff-like changes as unnecessarily alarming and criticized its retrospective methodology.
• ▪Elina Safro, education chair of the Australasian Menopause Society, stated that the physiological cliff theory is not plausible due to reliance on retrospective self-reported menopause data.

Debatable claims

• ▪Clinicians should begin routine menopausal health screening around age 40
• ▪Menopause marks an abrupt physiological shift across body systems
• ▪Describing menopause as a physiological cliff causes unnecessary patient anxiety