Feel Like You’re Aging Overnight In Menopause? Here’s How to Regain Control.

We often talk about aging as a slow, steady process, but for women in menopause, it can feel like it’s happening at twice the speed. Wrinkles deepen, skin sags, weight creeps up, and bones seem weaker. Science is beginning to confirm what women have long suspected: the body undergoes rapid, measurable shifts during this period of time that go beyond a loss of estrogen and progesterone.

Below experts explain why—and what to do about it.

About the Experts

Andrea Maier, M.D., Ph.D., is a healthy longevity expert and director of the NUS Academy for Healthy Longevity at the Yong Loo Lin School of Medicine at the National University of Singapore

Candice Knight, M.D., M.P.H., is an integrative physician and CEO of Knight Wellness in Louisiana

Rapid Biological Aging After Menopause

A 2024 study found that both men and women experience two biological “bursts” of aging: one around 44 and another around 60. ¹ For women, these roughly correspond to perimenopause and menopause.

The timing suggests that perimenopause and menopause aren’t just reproductive milestones—they happen alongside spikes in biological aging that can impact long-term health and disease risk.

Let’s break down how hormonal shifts may affect cellular and biological aging.

Epigenetics and menopause

Menopause triggers epigenetic changes that may accelerate biological aging.

Epigenetics is how behaviors (like diet, sleep, exercise, stress) and environmental factors (such as toxin exposure) affect gene expression—whether a gene is turned “on” or “off”—affecting how your body works without changing your DNA. ²

A 2016 study published in PNAS suggests that menopause may speed up the aging process by impacting gene expression. Researchers used an epigenetic clock—which measures how old certain cells “act” by assessing chemical changes to DNA—and found that women who’d gone through menopause had a higher epigenetic age (their cells acted older) compared to premenopausal women of the same chronological age. ³

“Menopause acts as a biological transition point that accelerates underlying aging mechanisms at the molecular level,” says Andrea Maier, M.D., Ph.D., director of the NUS Academy for Healthy Longevity at the Yong Loo Lin School of Medicine at the National University of Singapore.

Estrogen, progesterone, and testosterone help regulate the expression of genes that support repair, immune function, oxidative stress response, and cellular resilience, explains longevity expert and integrative physician, Candice Knight, M.D.

When levels of these hormones decrease, genes linked to age-related decline can become more active, raising the risk for chronic conditions commonly seen in menopause, like cardiovascular disease, cognitive decline, osteoporosis, and insulin resistance.

Menopause and inflammation

When we lose estrogen during menopause, inflammation increases, our tissues degrade, and cellular senescence—when cells stop multiplying and release chemicals that also trigger inflammation—increases. ⁴

Loss of estrogen is also specifically associated with a rise in pro-inflammatory cytokines, small proteins that trigger inflammation to fend off threats. ^{5 6} If they stay activated, it can lead to systemic inflammation sometimes referred to as “inflammaging.” ⁷

As estrogen decreases and inflammation increases, it makes us more vulnerable to illness and infection. ^{8 9}

Estrogen, oxidative stress, and aging

Estrogen is an antioxidant in the body. When levels decrease, oxidative stress increases. ¹⁰ Oxidative stress releases free radicals, which can harm cells and speed up aging during the menopause years. ^{11 12}

Metabolic changes during menopause

Estrogen helps with glucose uptake, making it easier for our bodies to process sugar, respond to insulin, and convert glucose into energy. As estrogen levels decrease, our cells become less responsive to insulin, which makes it harder to keep blood sugar in balance.

“Menopause increases insulin resistance, raising the risk for metabolic syndrome and type 2 diabetes,” says Maier. Menopause also affects energy metabolism, which can lead to weight gain, especially around the midsection. ¹³

Telomeres and hormone loss

Some studies suggest that menopausal transition may be linked to another biological aging marker: telomere shortening. ¹⁴ Telomeres are the protective caps on the ends of our chromosomes, and they have been shown to shorten more rapidly under chronic stress, inflammation, and metabolic dysfunction, “all of which can be exacerbated by hormone loss,” says Knight.

Telomeres are sometimes compared to the plastic tips on shoelaces—when they get too short or frayed, the chromosome (or shoelace) is more likely to break down.

Cardiovascular aging in menopause

Strong cardiovascular health is linked to slower physical aging. ¹⁵ Unfortunately, menopause can have a negative impact on heart health. “Estrogen maintains endothelial function, arterial flexibility, and favorable lipid profiles,” says Maier. “Its decline contributes to increased blood pressure, atherogenesis, and myocardial risk.”

Menopause, Estrogen, and Aging Skin and Hair

From dryness, wrinkles, sagging, and age spots to thinning, shedding, and proliferating grays, the hormonal changes of menopause are most noticeable in our skin and hair. “Estrogen helps maintain skin thickness, elasticity, and hydration by supporting collagen production and circulation,” Maier explains.

Declines in estrogen can result in:

• Dry, thinning skin
• Increased wrinkling
• Hair thinning
• Hair shedding
• Hair loss

And it’s more than a concern about the appearance of menopause wrinkles. “Thicker, better-hydrated skin with stronger collagen support plays a role in barrier function, wound healing, and resilience to injury—all of which decline with age,” says Knight.

Because estrogen plays a crucial role in collagen production and skin health, estrogen-based HRT can help offset menopause wrinkles.

“Multiple studies have shown that estrogen therapy, particularly transdermal or topical formulations, improves skin health by increasing collagen content, enhancing skin thickness and elasticity, and improving hydration and vascular perfusion,” says Maier.

Could Estrogen Delay Aging in Menopause?

There are no clinical trials that show hormone replacement therapy (HRT) delays aging. And the Menopause Society specifically calls out the idea that HRT can reverse or delay aging as “misinformation” and discourages women from seeking it out for that reason. ¹⁶

That said, researchers are becoming increasingly interested in the potential impacts of hormone therapy on biological aging and the role it may play in how the body functions at the cellular level over time.

• One 2024 observational study by Chinese researchers determined the phenotypic age—an estimate of biological age calculated using a set of clinical biomarkers—of more than 100,000 postmenopausal women. They concluded that women who’d received HRT at some point in their lives were slightly biologically younger based on these biomarkers than their counterparts who hadn’t taken hormone therapy. ¹⁷ (The effect was strongest in women who had been given HRT during perimenopause and those of lower socioeconomic status.)
• A small older study, also out of China, found that postmenopausal women who had received hormone therapy for more than five years had longer telomeres—a biomarker for less advanced biological age—than women who had never been on HRT. ¹⁸

“Hormone therapy is not a one-size-fits-all solution, and decisions around its use should be individualized based on a woman’s health history, risk factors, and personal goals,” says Knight.

Even in the absence of hormone therapy, she adds, women have powerful tools at their disposal. “Lifestyle factors like sleep, stress, circadian alignment, metabolic health, and even mindset can help mitigate these biological ‘bursts’ and promote more graceful, resilient aging.”

About the author

Jen Laskey is a veteran health and wellness journalist with over a decade of experience and a member of the Association of Health Care Journalists. Her work has appeared in outlets including NBC News, MSN, and The Healthy. With a gift for translating complex science into clear, engaging content, she helps readers make sense of their health and take informed action.

About the reviewer

Natalie Kunsman, M.D., is a board certified physician specializing in functional, anti-aging, and regenerative medicine. She is a fellow of the American Academy of Anti-Aging medicine and the American Academy of Family Physicians.