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Karen Barbara Alonso

@karenbar4

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Posted On: September 6th 2026, 03:55 pm

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Estradiol, FSH, and AMH start shifting 12 to 15 years before the final period, on average. For a woman whose last period comes around 50, that’s her late 30s, roughly 7 years earlier than the timeline most of us were trained on from the SWAN study.
That’s one finding from a study published this week in Nature Medicine (2026) by researchers at the Weizmann Institute, who analyzed more than 300 million lab tests from over a million women in the US and Israel. At the final period, 52 of 90 lab tests showed a sudden jump: bone markers, liver enzymes, blood fats, kidney markers, and fluid balance. Men run through the identical analysis showed no jump at all. One change went the right way; iron and hemoglobin improved, likely because the bleeding stopped. In the year after the final period, 19 percent of women screened for moderate to severe depressive symptoms, compared with 11 percent in the years that followed.
Women using hormone therapy had much smaller jumps, especially in bone, liver, and kidney markers. The bone finding is consistent with what randomized trials have already shown. The rest is observational (only about 9 percent of the US women were on hormones, mostly oral), and the authors say it needs trials. This was also a snapshot of women at different ages, not one woman followed through the transition.
In my practice, I don’t wait for the last period to start looking. If you’re in your 40s, ask for a baseline: lipids, a liver panel, a bone risk conversation, and a mood screen.
Menopause was never just hot flashes; now it shows up in the bloodwork. You deserve care that starts when your hormones do.
This post is for education and is not individual medical advice.
Source: Pridham G, Hayut Y, Lavi-Shoseyov N, Neeman M, Hovav N, Toledano Y, Alon U. Population-scale reconstruction of menopause dynamics reveals a physiological cliff at the final menstrual period. Nature Medicine. 2026;32:3823-3831. doi:10.1038/s41591-026-04614-0