The menopause transition is a pivotal stage in a woman’s life, marked by physiological and psychological changes that influence overall well-being. This chapter introduces an equity-centered framework that examines how menopause intersects with the social determinants and downstream factors shaping women’s health outcomes. It explores the sociocultural context, including how aging norms and cultural attitudes influence menopause experiences, and reviews the effects of discrimination and adverse childhood experiences on vasomotor and mood symptoms. The built environment is considered, focusing on housing stability, neighborhood safety, and access to green spaces. Socioeconomic status, food insecurity, and dietary inequities are analyzed for their roles in symptom burden and healthcare access. The chapter also addresses how social factors—such as income, education, race, and ethnicity—impact cardiovascular risk during the menopause transition. Biological and behavioral aspects are discussed, including the effects of physical activity, sleep, tobacco, alcohol, chronic stress, and allostatic load on health outcomes. Healthcare system gaps are highlighted, including limited clinician training and structural barriers to care. Finally, a culturally responsive care model is proposed to reduce inequities through cultural curiosity, respectful inquiry, and connected care. By integrating biological, behavioral, and societal factors, this framework supports health equity and informs policies that foster supportive environments for women navigating the menopause transition.