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Menopause, Midlife Hormone Changes and Healthy Aging

A plain overview of menopause and the gradual drop in testosterone in men, what major trials and regulators say about hormone treatment, and why hormones are not an approved anti-aging treatment.

Content last updated . This page has not been medically reviewed.

Hormone changes are part of aging, not a disease

Sex hormone levels change through midlife. This page is an overview only; detailed trial reviews are on Menopausal Hormone Therapy and Aging: What the Trials Show and Testosterone Therapy and Aging: Trial Evidence and Risks. Hormone medicines are prescription drugs. Nothing here is advice to start, stop or change one; that decision belongs with you and your prescriber.

Evidence labels: approved medicine (named regulator and use), established, mixed, insufficient evidence.

Menopause

The National Institute on Aging calls menopause "not a disease or disorder" but a normal part of aging. It is the point when periods stop permanently, and the years leading up to it are the menopausal transition. Most women begin the transition between 45 and 55, and it may last several years. [1] The NHS says menopause is defined as 12 months without a period, and that symptoms usually last 7 to 9 years, sometimes longer, and can change over time. [2] Symptoms are wide-ranging, from hot flushes and night sweats to low mood, joint aches and sleep problems. [2] For everyday information see Perimenopause and Menopause.

Midlife changes in men

In men, testosterone levels fall as they age, and MedlinePlus notes that the normal range is much lower in a man of 50 to 60 than in a man of 20 to 30. [3] The popular word for this is "andropause", but the sources we read describe a gradual decline, not a sudden event like menopause. A low reading can also come from medical causes such as pituitary problems, some medicines, or rapid weight loss. [3] Because of those causes, symptoms such as low interest in sex or muscle loss deserve a medical check rather than a supplement. See Testosterone and Low Testosterone.

Bone and menopause

Bone loss speeds up in the first years after menopause. [11] See Bone Health, Osteoporosis and Aging.

Frequently asked questions

Is menopause a medical condition?

The NIA describes it as a normal part of aging, not a disease. [1]

Does hormone therapy help women live longer?

In the Women's Health Initiative follow-up, hormone therapy was not associated with all-cause mortality over 18 years. [5]

Did the FDA say hormone therapy is now safe?

No. In February 2026 it approved label changes that removed some boxed warning statements; its announcement does not say risks are gone. [6] Cardiovascular and breast cancer risks were the subject of the earlier trial. [4]

Is testosterone approved to treat aging?

The FDA says none of its approved testosterone products are approved for low levels without an associated medical condition. It requested label changes in June 2026. [9]

Is "andropause" the male version of menopause?

The sources we read describe a gradual testosterone decline in men, not an abrupt stop. [3]

More details: evidence, limits and cautions

The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.

Hormone therapy for menopause: what the evidence and regulators say
  • Large trial, combined estrogen plus progestin. The Women's Health Initiative randomized 16,608 postmenopausal women aged 50 to 79 with a uterus. It was stopped after a mean 5.2 years because breast cancer risk exceeded the stopping boundary. Compared with placebo, hazard ratios were 1.29 for heart disease, 1.26 for breast cancer, 1.41 for stroke and 2.13 for blood clots in the lungs, with fewer hip fractures (0.66) and colorectal cancers (0.63). The authors concluded the regimen should not be started for primary prevention of heart disease. [4]
  • Long-term follow-up. After 18 years, deaths from any cause were not different between hormone and placebo groups (hazard ratio 0.99 pooled), for cardiovascular or cancer deaths either. The ratio differed by age at randomization, with a lower ratio in women 50 to 59 than 70 to 79 during the trial. [5] Mixed: no lifespan benefit overall, and age at starting matters.
  • Regulator. In February 2026 the US FDA approved label changes for six menopausal hormone products that removed cardiovascular disease, breast cancer and probable dementia statements from the boxed warning, after starting that process in November 2025. The FDA states that its approved uses include moderate-to-severe hot flashes, vaginal dryness and preventing bone loss. [6] This is a regulatory press announcement, not a new trial.
  • NHS view. The NHS says benefits usually outweigh risks for women under 60 with symptoms who are not at high risk of breast cancer or blood clots, and notes a small increase in breast cancer with combined HRT (about 5 extra cases per 1,000 women over 5 years), a very low blood clot risk with tablets, and none with patches, gels or sprays. [7]
  • Not an aging treatment. The approved uses the FDA lists are symptom relief and preventing bone loss; aging itself is not among them. The FDA announcement says randomized studies show lower all-cause mortality and fewer fractures in women who start within 10 years of menopause onset, while the trial follow-up above found no overall difference in deaths, so the mortality question remains mixed. [6][5]

Non-hormone medicines and other approaches are also used for hot flashes. [8] For herbal products see Botanicals for Menopause and Hormone Claims.

Testosterone in men: what the evidence and regulator say
The FDA says testosterone products are approved for men who lack or have low testosterone with an associated medical condition, and that none are approved for men with low levels and no associated condition. In June 2026 it requested label updates, including removing the limitation of use stating that safety and efficacy in age-related hypogonadism had not been established. [9]

The TRAVERSE trial randomized 5,246 men aged 45 to 80 with symptoms of low testosterone and existing or high risk of cardiovascular disease to a testosterone gel or placebo for a mean 21.7 months of treatment. Major cardiovascular events occurred in 7.0% versus 7.3% (hazard ratio 0.96), meeting the noninferiority goal. More atrial fibrillation, acute kidney injury and lung blood clots were seen with testosterone. The trial was funded by the manufacturer and others. [10] A trial of this length cannot show an effect on lifespan or on aging. Insufficient evidence for any aging benefit.

Safety
Risks differ by form and by person, and the NHS says someone who has had breast cancer will usually be advised not to take HRT. [7] The NHS advises contacting a GP about any vaginal bleeding after 12 months without a period. [2]
References
  1. National Institute on Aging. What is menopause?. Read 2026-10-22.
  2. NHS. Symptoms of menopause and perimenopause. Page last reviewed 19 May 2026. Read 2026-10-22.
  3. MedlinePlus. Hypogonadism. Read 2026-10-22.
  4. Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA. 2002. Read 2026-10-22.
  5. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials. JAMA. 2017. Read 2026-10-22.
  6. US Food and Drug Administration. FDA Approves Labeling Changes to Menopausal Hormone Therapy Products. February 12, 2026. Read 2026-10-22.
  7. NHS. Benefits and risks of hormone replacement therapy (HRT). Page last reviewed 8 February 2023. Read 2026-10-22.
  8. NHS. Treatment for menopause and perimenopause. Page last reviewed 19 May 2026. Read 2026-10-22.
  9. US Food and Drug Administration. Testosterone Information. Content current as of 06/23/2026. Read 2026-10-22.
  10. Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE). N Engl J Med. 2023. Read 2026-10-22.
  11. NHS. Osteoporosis. Page last reviewed 13 October 2022. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.