Perimenopause

Transitional phase before menopause, typically starting in late 30s to mid-40s.

Signs and Symptoms:

• Irregular menstrual cycles
• Hot flashes, night sweats
• Mood instability
• Insomnia
• Estrogen dominance symptoms
• Shortening of the cycle
• Sleep disturbances
• Weight gain

Pathophysiology: Fluctuating estrogen and declining progesterone create hormonal imbalance and adrenal stress.