Hormones are signaling molecules that regulate cellular activity throughout the body. By binding to specific receptors, they coordinate metabolism, neurologic function, skeletal integrity, cardiovascular health, reproductive physiology, and much more. Hormone levels change predictably with age and life transitions, altering how efficiently the body maintains physiologic balance. These shifts may influence energy, cognition, sleep, musculoskeletal health, and overall vitality. 

Understanding the role of hormones allows for restoration of balance, optimizing function, and supporting long term health. 

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Perimenopause is the transition leading up to menopause, it may begin as early as the late 30s or mid-40s. During this time, estrogen and progesterone levels fluctuate unpredictably, which may cause symptoms even when lab values appear "normal."

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Menopause is define retrospectively. It is defined as 12 consecutive months without a menstrual cycle. At this point, ovarian estrogen and progesterone production has declined significantly and permanently. 

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Estrogen maintains bone remodeling, supports endothelial and cardiovascular function, preserves vaginal and urinary tissue integrity, and plays a role in thermoregulation and cognitive processing. During perimenopause, estrogen levels fluctuate unpredictably before declining in menopause. This variability, not just low levels, drives many symptoms. Long term estrogen deficiency is associated with accelerated bone loss and increased fracture risk, as well as changes in genitourinary tissue, and neurologic function. 

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Progesterone counterbalances estrogen's effects on the lining of the uterus and plays an important role in sleep regulation and nervous system stability. Progesterone may start to decline earlier than estrogen in perimenopause, contributing to sleep issues, anxiety, and menstrual changes. 

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Testosterone contributes to muscle mass, bone density, sexual function, and cognitive vitality. Testosterone production gradually decreases with age. 

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DHEA serves as a precursor to both estrogen and testosterone. It contributes to immune function, energy metabolism, and stress resilience. DHEA declines with age.