The rising life expectancy far beyond any historical records presents serious demographic and socioeconomic changes to society with critical challenges for healthy aging. The burden of the menopause-related diseases will invariably increase in the coming years including the risk of osteoporosis, cardiovascular disease, dementia and cognitive decline. The main reason is loss of ovarian function and circulating concentrations of sex steroids.

Existing therapies to reduce the burden of menopause-related diseases (i.e. hormone therapy, lifestyle changes and alternative medications) apparently have their shortcomings and are only partly capable of solving the problem, implying that new alternative solutions are warranted.

The present review emphasizes that ovarian follicles are present in huge surplus during most of the reproductive active years and that current technology allows cryopreservation of resting follicles, apparently with little consequences for the woman’s reproductive abilities. Based on the multitude and complexity of oestrogen and progestin signalling pathways active and its intricate control in target cells throughout the body, we suggest that ovarian tissue transplanted back into the woman herself after menopause will allow for continued menstrual cycles with the whole armamentarium of hormones and growth factors released naturally from the follicle and the corpus luteum. This option has been termed cellular hormone replacement therapy. This new solution needs to be backed by clinical trials, extensive research and investigations of potential side effects to qualify as a valid alternative to existing therapies.