Is there a 'cliff-like' decline at menopause? Australian experts skeptical

A new study published in Nature Medicine suggests that menopause-related biological changes across multiple body systems occur abruptly, rather than gradually, marking a "cliff-like" decline. Australian experts caution that the study has limitations and call for further research. For women approaching menopause, they recommend not smoking, limiting alcohol, eating well, and staying active.

Menopause signifies the end of a woman's reproductive years and is associated with various changes, including bone thinning, weight gain, and bladder issues. Researchers analyzed over 300 million laboratory tests from over 1 million women in the US and Israel between 1999 and 2024, discovering sudden, step-like changes across nearly all physiological systems at menopause.

However, Australian experts urge caution in interpreting the results, deeming the claim as "unnecessarily alarming." Highly respected studies, such as the US Study of Women's Health Across the Nation (SWAN), indicate that these changes are gradual, occurring over approximately three years. The new study employed a mathematical approach to align large-scale data at the final menstrual period, uncovering the "cliff" effect.

While the study found accelerated changes 15 years before menopause, seven years earlier than the SWAN study, medical professionals remain skeptical, highlighting that the study relied on retrospective data and self-reported information. Despite the skepticism, some aspects of the study are noteworthy, such as the earlier onset of changes and the potential benefits of menopausal hormone therapy (MHT) in maintaining bone health.

However, experts emphasize that healthier women are more likely to use MHT, which may explain the observed benefits. They also stress that MHT is not a proven preventive measure against chronic conditions such as cardiovascular disease and dementia. Experts recommend regular health checks during menopause, focusing on bone health, cholesterol, blood pressure, and blood sugar, and urge women to consult their GP in their 40s regarding symptoms, health, and potential hormone therapy.