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Bone, liver and blood-fat markers jump at menopause in lab records from over a million women

Weizmann Institute researchers analyzed more than 300 million lab tests from over a million women and report step-like shifts at menopause. In the Nature Medicine paper the largest changes sit in bone metabolism, liver tests and lipid handling.

The Scientist · Science desk

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Photograph accompanying Bone, liver and blood-fat markers jump at menopause in lab records from over a million women
Photo: nature.com
Hormone signs appear years before menopause US lab tests with a sudden change at menopause, when AMH decline signs appear before the end of menstruation, and the study's lab test count.

Key figures: 52 of 90 laboratory tests in the US dataset showed a statistically significant sudden change with menopause; AMH showed signs of decline around 15 years before the end of menstruation; the study uses more than 300 million lab tests.

Hormone signs appear years before menopause
FigureValueNoteClaim
US lab tests with a sudden change at menopause52 of 90 tests2
AMH decline signs, around15 years before9
Lab tests, more than300,000,000 tests4

What happened

  • Pridham's group ran a computational framework on two large cohorts, one in the United States and one in Israel, built to separate chronological age from reproductive timeline, a confound that has complicated earlier population-wide studies.
  • Both cohorts showed what the authors call a step-like physiological cliff at the final menstrual period, across nearly all physiological systems.
  • In the US dataset, 52 of the 90 laboratory tests showed a statistically significant and sudden change at menopause.

Why it matters

  • constraint The study is observational, and Andrew Shelling of the University of Auckland, who was not involved, calls the results interesting but not conclusive.
  • contradiction The paper's hormone timeline puts the first signals more than a decade before the final period: AMH and oestradiol fall about 15 and 12 years ahead and FSH rises about 14 years ahead. 'Abrupt' describes the lab markers at that point, not the run-up to it.
  • capability Physiologist Mia Schaumberg, an outside commentator, says the hormone timing means systemic changes at menopause could be predicted much sooner than originally thought.

The paper takes on the assumption that menopause is a gradual part of aging [15]. To test that, the comparison group matters most. Anything driven by calendar age alone should turn up in men as well, and the authors report that it does not. In their words, "the cliff is a consequence of the menopausal transition rather than general aging" [7].

The pattern of which tests moved is a second check. In the US data 52 of the 90 tests changed significantly, which leaves 38 that did not [14]. Physiologist Mia Schaumberg of the University of the Sunshine Coast, who was not involved, said "The systems where the most significant changes were seen (e.g. bone health, or the liver) are very sensitive to estrogen, and systems that didn't show detectable changes have a much weaker known link to estrogen" [3].

The thing this doesn't tell you is how large the steps are. ScienceAlert's account of the paper gives the 52-of-90 count for the US cohort only and does not report an effect size for any test, or a test count for the Israeli cohort.

That gap matters because of the objection from Martha Hickey, a professor of obstetrics and gynecology at the University of Melbourne who was not involved. She said the cliff description is "potentially alarming for women and implies a dramatic physical and mental decline, which this study does not demonstrate" [8]. A statistically significant jump in a blood value is a statement about the blood value. Whether it carries a symptom or a loss of function is the step Hickey says the study does not take.

Other work reporting widespread changes at menopause has used a different frame: a sudden "career change" for the body and brain, in place of a "reproductive retirement" [13].

In our view the age-only explanation is hard to hold for the tests that moved, given the male comparison and the estrogen pattern. Andrew Shelling of the University of Auckland, who was not involved, said the study "opens a new way of thinking about menopause and provides a new framework for future research" [12].

What to watch

  • Effect sizes for the 52 US tests and the matching test count from the Israeli cohort, which the coverage does not report.
  • Longitudinal follow-up of individual women that could test the step against the observational design Shelling flags.
  • Work linking any lab step to symptoms or function, the gap Hickey says the study leaves open.

Clarity's read

What the record supports and how the coverage leans. The claims behind it follow.

Reality

Evidence62
Adoption
Insufficient
Hype gap+25
Incentives
Insufficient
Confidence45
Why these scores

Claim ledger

Ranked by verification strength, evidence, and original report placement.

  1. [1]

    The changes are most pronounced in systems such as bone metabolism, liver tests, and lipid handling.

  2. [2]

    In the US dataset, 52 of 90 laboratory tests showed a statistically significant and sudden change with menopause.

    ReportedSupportedSource: ScienceAlert summary of the paper2 sources— create a free account to open themView cited source
  3. [3]

    Physiologist Mia Schaumberg of the University of the Sunshine Coast, who was not involved in the study, explains: "The systems where the most significant changes were seen (e.g. bone health, or the liver) are very sensitive to estrogen, and systems that didn't show detectable changes have a much weaker known link to estrogen."

    ReportedSupportedSource: Mia Schaumberg, University of the Sunshine Coast, quoted by ScienceAlert2 sources— create a free account to open themView cited source

Sources

1 independent publisher whose own reporting we read for this story.

  1. sciencealert.com

    1 article · October 12, 2026

    Bones, Liver, And Blood Fats All Shift Abruptly at Menopause, Huge Study Finds

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