Population-scale reconstruction of menopause dynamics reveals a physiological cliff at the final menstrual period.

Large-scale analysis uncovers a step-like physiological cliff at the final menstrual period in women, affecting multiple systems including endocrine, skeletal, hepatic, renal, and lipid.

• Why it matters: Understanding menopause as a gradual process has been limited by small cohorts and lack of FMP data, hindering insights into systemic physiological changes during this transition.
• What they did: A computational framework inspired by astronomy was used to reconstruct FMP-anchored trajectories from cross-sectional data across two cohorts totaling 300 million tests, revealing discontinuities at FMP.
• The result: Findings show a physiological cliff absent in males, consistent across populations, attenuated by hormone therapy, and beginning over a decade before FMP, offering a systemic view of menopause.