Frailty and menopause: A gateway to healthy aging

Frailty is a clinical state arising from the progressive erosion of physiological reserves across multiple systems, resulting in heightened vulnerability to stressors and an increased risk of adverse health outcomes. Strategies to promote healthy aging may benefit from the early identification of frailty and the implementation of targeted interventions aimed at mitigating or potentially reversing this condition. Interest in frailty within the context of women's health stems from epidemiological evidence indicating that women have a higher risk of developing frailty than men. Moreover, menopause has been associated with an increased susceptibility to frailty. On this basis, the present review examines the contribution of key hormonal factors involved in the physiological changes accompanying menopause to the development of frailty in women. Specifically, it focuses on steroid-related pathways, including estrogens, androgens, and vitamin D. By integrating the available evidence, this review aims to clarify their potential roles in frailty susceptibility during midlife and beyond. There are some indications, albeit based on limited evidence, of a protective role of menopausal hormone therapy. Encouragingly, healthy dietary patterns and regular physical activity have demonstrated efficacy in mitigating frailty, reinforcing the importance of lifestyle strategies to counteract the adverse effects of menopause.