The concept of women’s long-term health and longevity implies maintaining the quality of life, including a discussion of the role of hormone replacement therapy within the ‘therapeutic window’. Aging is a complex multi-step process. It is believed that women begin to experience the effects of aging at the age of 40. The processes of age-related changes in the body are being actively studied these days and include markers, models, systems, but there is no unified concept yet. In recent decades, there has been an increase in life expectancy for women, hence there are more women in menopause, and an increase in the incidence of age-related diseases can be expected. With the onset of menopause and age-related changes, women may experience metabolic disorders, cardiovascular diseases, endothelial dysfunction, disorders of both the central and peripheral nervous systems, musculoskeletal disrders and mental health problems. Over past decades, attention has been paid to cellular markers of aging, and the telomere theory has been most developed. It is associated with shortening of telomeres – the end regions of chromosomes. Many studies in recent years have examined the mechanisms influencing the length of these regions, the activity of the telomerase enzyme, and the processes of reproductive aging associated with this theory. In the 20th and 21st centuries, the possible effect of exogenously administered estrogen on telomere length as part of hormone replacement therapy has been under active consideration. Key words: insulin resistance, menopause, telomeres, telomerase, type 2 diabetes, aging, hormone replacement therapy