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Perimenopause, which typically occurs in a woman's mid-40s, precedes menopause

Sometimes referred to as the menopausal transition, perimenopause often lasts around four 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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