In today’s power hour we discuss menopause. Before going on hormone replacement therapy, it is important for women to consider the risks. By supporting the clearance of hormones in the liver, by choosing bio-identical hormones, and by using delivery routes besides oral, a woman can decrease her risks of adverse events like heart disease from hormone replacement therapy. Many women realize that menopause is a natural process, and choose not to use HRT to decrease symptoms. Liver health is important for these women as well, and phyto-estrogens may be helpful for them as well. To prepare for peri-menopause, adrenal support can help prepare these glands to take over sex hormone production as ovarian function decreases. In reproductive age women, PCOS is the most common disease, although this poorly defined and probably includes multiple causes that have similar symptoms. Women need a thorough workup including all sex hormones, adrenal function, and metabolic markers to properly address the underlying cause of their hormone imbalances.