Menopause Care for Whole-Body Optimization: 6 Key Findings from the 2025 Menopause Society Meeting

The Annual Menopause Society meeting, held this past week, is the leading global forum on menopause science and a bellwether for what’s next in midlife women’s health. Each year’s findings often shape upcoming clinical guidelines and reframe how menopause is understood and managed worldwide.

This year’s through-line: “Much of the research at this year’s meeting underscores that menopause is a window for optimization—when proactive, personalized care can change long-term health trajectories,” says Jim Staheli, D.O., Medical Director at Hone.

Most of the findings presented were posters and abstracts, meaning they are early-stage findings that point to where the science is heading rather than rewriting the rulebook today. Still, they offer an exciting glimpse of how menopause and longevity medicine are converging.

Starting Estrogen Earlier May Protect Long-Term Health

Women who started estrogen therapy during perimenopause had about 60 percent lower odds of developing breast cancer, heart attack, and stroke than those who began after menopause or never used hormones, according to a poster presented by researchers at Case Western Reserve University School of Medicine and University Hospitals in Cleveland.¹

Women who started HRT later saw little cardiovascular benefit and a small (~4.9 percent) uptick in stroke risk. While preliminary, these results support what’s known as the timing hypothesis—the idea that beginning hormone replacement therapy closer to the menopause transition (before 60 or within 10 years of menopause) may help women hang on to some of estrogen’s protective effects for blood flow, cholesterol, and blood sugar.²

Those benefits appear to fade once menopause is well underway. ^{3 4 5}

The data are observational and haven’t yet been peer-reviewed, so more research is needed to confirm the connection. For now, the U.S. Preventive Services Task Force still advises against using hormone therapy to prevent chronic disease in postmenopausal women. ⁶ Still,  the research adds weight to an emerging view: When women start hormone therapy may matter just as much as whether they do. 

HRT May Boost Weight-Loss Response to GLP-1s

For many women, menopause makes weight loss feel like an uphill battle. But new research from the Mayo Clinic in Jacksonville suggests that hormone therapy (HT) might enhance results with the new generation of GLP-1 medications like tirzepatide (Zepbound).

In the study, women who were postmenopausal and using hormone therapy lost an average of 20 percent of their body weight after 18 months on tirzepatide—significantly more than postmenopausal women not on HRT, who lost around 16 percent. Their results were nearly identical to those of pre- and perimenopausal women.⁷

Researchers believe estrogen may influence how the body responds to GLP-1s like tirzepetide, liraglutide, and semaglutide by influencing metabolism, fat distribution, and appetite regulation. Another factor may be that hormone therapy helps ease symptoms—like sleep disruption and fatigue—that can derail lifestyle changes needed for lasting results.

“This is an early but important signal,” says Staheli. “It suggests hormone therapy could help level the playing field for women whose metabolic response changes after menopause.

Early Menopause May Raise the Risk of Metabolic Syndrome

Women who reach menopause before age 45 face a 27 percent higher risk of developing metabolic syndrome, a condition that dramatically raises the odds of heart disease, stroke, and diabetes. That’s according to new research from the University of Pennsylvania, which analyzed medical records from more than 234,000 women between the ages of 30 and 60.⁸

Even after accounting for factors like weight, race, and medication use, the pattern held: The earlier estrogen levels decline, the earlier metabolic dysfunction begins. 

Metabolic syndrome is a cluster of red flags—including high blood pressure, elevated blood sugar, increased abdominal fat (aka menopause belly), and abnormal cholesterol—that together accelerate aging across multiple systems.

Previous studies have already linked menopause to higher rates of cardiovascular disease and metabolic disease. ^{9 10 11} This new data adds an important dimension, suggesting that timing matters. 

“When estrogen declines, women lose a key layer of protection for their heart, blood vessels, and glucose regulation,” says Staheli. “We can’t delay menopause (yet), but by tracking biomarkers and recognizing early changes, we can catch metabolic risk sooner and take steps to prevent downstream disease.”

Early Menopause May Also Compound Cognitive Risk

Women who go through premature menopause may also face double jeopardy for brain health. A new study from the University of Toronto and Sunnybrook Research Institute found that early menopause, combined with reduced heart function, was linked to faster brain aging—including changes in the brain’s wiring and structure—on MRI scans of more than 500 women. ¹²

Heart function was measured using something called ejection fraction, or how much blood the heart’s main pumping chamber pushes out with each beat. When that number is low, the brain gets less oxygen and nutrients. 

Women who had both early menopause and lower heart function showed the most signs of brain stress—less gray matter, the part of the brain involved in memory and decision-making, and more damage to the white matter, which helps different regions of the brain communicate.

The takeaway: When estrogen levels fall, it can set off a chain reaction that affects not just the heart but also the brain.

“This study shows exactly why integrated testing matters,” says Staheli. “When cardiac output drops, the brain gets less oxygen and blood flow—and if menopause happens early, that effect intensifies. By tracking estrogen levels alongside heart-health markers like blood pressure, cholesterol, and fitness capacity, we can identify risk sooner and take steps to protect both heart and brain function.”

Hormone Therapy and Anxiety: Promising, but Not a Cure-All

Anxiety can sneak up during menopause—showing up as racing thoughts, irritability, or that constant sense of being “on edge.” Hormone changes are partly to blame, but new research suggests estrogen therapy isn’t always the solution.

A review of seven studies involving more than 175,000 women found that hormone therapy didn’t reliably ease anxiety, though some women—especially those in the early stages of menopause—did feel better. Results varied depending on the type and amount of estrogen used, with pills showing a slight edge over estrogen patches. ¹³

Previous studies, including a 2018 randomized controlled trial in JAMA Psychiatry, have suggested menopause hormone therapy can help stabilize mood for some women. ¹⁴

Experts say anxiety in menopause is multi-layered, driven by shifting hormones, stress, sleep loss, and life changes happening at the same time. For most women, the best mood improvements come from a combination of approaches—addressing hormones when appropriate, improving sleep, and using tools like therapy, mindfulness, or medication when needed.

Provider Training Shapes Menopause Treatment Options

When it comes to menopause, your doctor may matter just as much as your symptoms.

Research from Wake Forest University found that only 17 percent of women who sought help for menopause symptoms received any prescription treatment at all. The study looked at nearly 5,500 women’s medical records and found big differences in care depending on the type of provider. ¹⁵

OB-GYNs and nurse practitioners were most likely to prescribe hormone therapy, while internal medicine and family doctors leaned toward antidepressants instead.

The reason why it’s hard to find a good menopause doctor may be surprisingly simple: Most doctors get very little formal training in menopause. Fewer than 10 percent of medical residents report feeling prepared to manage menopause when they graduate, according to a study published in Mayo Clinic Proceedings. ¹⁶

“This study highlights what many women already know—access to quality menopause care is inconsistent,” says Staheli. “When providers aren’t trained in hormone management, patients can miss out on options that could really improve their quality of life. The solution isn’t just more prescriptions—it’s better education and evidence-based care.”

What This Means for Longevity-Focused Menopause Care

The science presented at this year’s Menopause Society meeting reinforces that menopause isn’t just a phase marked by hot flashes or insomnia. It’s a biological turning point that shapes long-term health across every system in the body.

Menopause hormone therapy remains the most effective treatment for symptoms, but timing clearly matters. The benefits appear strongest when treatment begins close to the menopause transition.

At the same time, early menopause stands out as a marker of higher vulnerability to metabolic, cardiovascular, and cognitive decline. That makes proactive screening and personalized prevention even more essential.

Consistency in care also matters. With most physicians receiving minimal menopause education, improving training and access to evidence-based care is critical to closing the gap between what the science shows and what patients actually experience.

“The future of menopause care lies in precision medicine,” says Staheli, “using biomarkers, cardiovascular fitness, and hormone timing to guide truly individualized interventions.”

About the author

Tracy Middleton is the Senior Editorial Director at Hone and an award-winning health journalist and editor with more than 20 years’ experience. She is the former Editor in Chief and Brand Director of Yoga Journal and former Health Director of Women’s Health, and a member of the Association of Health Care Journalists.