New large-scale study identifies patterns of dietary intake, physical activity, and sleep across menopause and hormone therapy groups
CLEVELAND, Ohio (June 17, 2026)—Menopause is associated with a number of adverse health effects, some of which can be mitigated by an array of modifiable health behaviors (MHBs), including diet, exercise, and sleep duration. A new study sought to determine whether menopause and hormone therapy status had any association with MHBs. Initial results suggest that a link exists. Results of the study are published online today in Menopause, the journal of The Menopause Society.
During the menopause transition, there is a significant increase in the risk of chronic diseases, along with an increased incidence of such bothersome symptoms as hot flashes and urogenital problems. The use of hormone therapy often serves as a treatment option to manage these menopause symptoms. However, whether hormone therapy affects health outcomes and chronic disease risk directly or indirectly through altered health behaviors is unclear.
Research to date around this topic has produced mixed results, with some research suggesting that postmenopausal women focus more on a healthy lifestyle. A first-of-its-kind cross-sectional analysis involving more than 10,000 women sought to identify to what extent menopause status and the use of hormones was linked with a healthy lifestyle as defined by diet, physical activity, and sleep duration.
The research showed that postmenopausal women who never used hormone therapy reported a lower intake of fruit and vegetables. Never-users of hormone therapy were 19% less likely to meet strength-based activity guidelines. Sleep duration was also shorter in postmenopausal women who had never used hormone therapy. The likelihood of meeting sleep guidelines was 14% lower in never, 26% lower in current, and 24% lower in past hormone therapy users compared with premenopausal and perimenopausal women.
According to the researchers, these findings may be related to elevated follicle-stimulating hormone levels, as expected in postmenopausal women who do not use hormone therapy, and the lower estradiol levels associated with menopause, which have been associated with poorer sleep. In addition, menopause-related hot flashes and urogenital symptoms can contribute to sleep disturbances, but these symptoms may be alleviated by hormone therapy.
Survey results are published in the article “Menopause and hormone therapy in relation to dietary intake, physical activity, and sleep and meeting lifestyle guidelines.”
“This large observational study underscores that women who use hormone therapy tend to adopt overall healthier lifestyles. Although this association may partly reflect better symptom control enabling healthier behaviors, healthy-user bias is likely a significant contributor. Women who choose to use hormone therapy are often more proactive in their healthcare and may systematically differ from nonusers in socioeconomic resources, access to care, and health literacy. This largely explains why early observational studies of hormone therapy suggested cardiovascular benefits that were not confirmed in subsequent randomized, controlled trials,” says Dr. Stephanie Faubion, medical director for The Menopause Society.
For more information about menopause and healthy aging, visit www.menopause.org.
The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public