Objective: To obtain data on the relation between age, menopause and homocysteine levels in women around menopause, we collected data for a sample of about 500 women attending a menopause clinic in Milan, Italy. Study design: Eligible for the study were all women aged 45-75 years, never HRT users consecutively observed for the first time at the Menopause Center of the 1st Obstetric Gynecological Clinic of the University of Milan. Fasting blood samples for total homocysteine plasma levels were collected during the visit. Of the 490 study subjects, 107 were pre-menopausal and 383 post-menopausal. Results: In the total series, the mean homocysteine level was 8.3 mu mol/L (S.D. 3.7, range 3.2-48.8). The values increased from 7.8 mu mol/L in women aged < 47 years to 9.0 mu mol/L in those aged > 59. Among pre-menopausal women the mean homocysteine level was 7.7 mu mol/L compared to 8.3 mu mol/L in post-menopausal women: this difference disappeared on the adjusted values. In post-menopausal women only, no clear relationship emerged between years since menopause and homocysteine levels. Conclusion: In our population, age, and not menopausal status, was the main determinant of homocysteine levels in women around menopause. (c) 2004 Elsevier Ireland Ltd. All rights reserved.