Reframing menopause and menopause hormone therapy as opportunities for healthy aging

Menopause is an important biological transition with up to 72 symptoms that shapes aging trajectories across organs and encompasses ~40% of the female lifespan. Although menopause awareness is increasing, research on strategies for menopause symptom management and optimizing health in the postmenopausal period is lacking. This Review highlights that menopause characteristics, such as type, timing, and symptom burden, influence health outcomes and later-life disease risk. Similarly, menopause hormone therapy comes in >200 varieties that differ by dose, formulation of estrogens and progestogens, and timing, each with their own distinct risk-benefit profiles. These distinctions are often missed in the literature but have considerable repercussions for outcomes. Optimized menopause care necessitates a precision medicine approach that considers menopause symptoms, genetics, and previous hormone exposures.