The relationship between serum urate, menopause, and aging has not been clearly defined by scientific evidence. In the present issue of Arthritis Research and Therapy, Hak and Choi present a cross-sectional analysis to clarify the effect of menopause and hormone replacement therapy on serum urate in women within the Third National Health and Nutritional Examination Survey. Menopause increased serum urate and hormone replacement therapy significantly decreased serum urate, although the overall level of change was small. The implications of these urate changes on gout and cardiovascular disease outcomes require further study.