LAUSR

The menopausal transition is a time of accelerated cardiovascular ageing and increased susceptibility to chronic diseases including cardiovascular disease (CVD). Growing data support a cardiovascular contribution to brain ageing, but characterization of this in women remains unclear. In an article in this issue of Experimental Physiology, Ruediger et al. characterized group differences in peripheral and cerebrovascular function and their respective associations with sex hormones and nitric oxide bioavailability in healthy middle-aged premenopausal (n = 10), early postmenopausal (n = 15) and late postmenopausal (n = 14) women (Ruediger et al., 2023). The authors should be applauded for conducting this comprehensive study and have taken an important step toward closing a critical gap in knowledge. Accordingly, we wish to highlight the importance of considering (i) the menopausal transition as a period of accelerated risk and clinical versus statistical significance, (ii) subject characteristics that may alter vascular ageing trajectories, and (iii) the paucity of data on cerebrovascular haemodynamics during menopause and importance of considering differing vascular methodology. First, the menopausal transition is an inherently physiologically dynamic period. Cross-sectional studies that exclude a portion of individuals (e.g., perimenopausal women) cannot account for the dynamic physiological changes during the menopausal trans-