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Perimenopause timeline and hormone changes What perimenopause is: Transition phase before menopause Typically begins ages 40-50 (average 45) Lasts 4-8 years on average (varies widely) Ends 12 months after final period Hormones fluctuate wildly (not just decline) Hormone patterns during perimenopause: Estrogen: Up and down unpredictably (not just low) Progesterone: Declines earlier than estrogen Testosterone: Gradual decline begins Growth hormone: Significant drop (20-30% by age 40) Thyroid: Often becomes imbalanced Cortisol: Increases (stress response changes) Why this is harder than menopause: Menopause = low hormones (predictable) Perimenopause = chaotic fluctuations (unpredictable) Can't predict how you'll feel day to day Harder to treat with traditional HRT Learn about peptides , how peptides work , and what are peptides used for in our foundational guides