I don't feel like re-inventing the wheel... so forgive the quotes that I found from the following article accessed on 7/16/2024: Brinton, R., Yao, J., Yin, F. et al. Perimenopause as a neurological transition state. Nat Rev Endocrinol 11, 393–405 (2015). https://doi.org/10.1038/nrendo.2015.82

"The clinical definition of perimenopause focuses on functional changes in the reproductive system; however, the symptoms of the perimenopause are largely neurological in nature

• Most women transition through perimenopause without long-term adverse effects; however, a substantial proportion of women emerge from this transition with an increased risk of neurological decline

• Estrogen functions as a master regulator to ensure the brain responds appropriately to coordinate signalling and transcriptional pathways that regulate energy metabolism

• The estrogen receptor network becomes uncoupled from the bioenergetic system during the perimenopausal transition and a hypometabolic state associated with neurological dysfunction emerges

• In neurological transition states, indicators of dysfunction at the limits of those normally seen can signal tipping points for neurological diseases

• The presence, variability, intensity and duration of neurological perimenopausal symptoms could be warning signs for increased risk of neurodegenerative diseases later in life"