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Perimenopause, which typically occurs in a woman's mid-40s, precedes menopause
Sometimes referred to as the menopausal transition, this time period often lasts around 4 years as the ovaries' production of the reproductive hormones progesterone and estrogen decline. It may be accompanied by mental and physical symptoms including irregular periods, hot flashes, sleep issues, mood swings, and alterations to a woman's sex drive.
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