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10.1182/blood-2008-03-040253 [DOI] [PMC free article] [PubMed] 13.Devalia V, Hamilton MS, Molloy AM (2014) Guidelines for the diagnosis and treatment of cobalamin and folate disorders

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Common perimenopause symptoms Hot flashes and temperature dysregulation: Sudden heat waves Night sweats disrupting sleep Chills after hot flashes Unpredictable timing Can happen dozens of times daily Mood and mental changes: Mood swings (rage, sadness, anxiety) Irritability (low frustration tolerance) Anxiety (new or worsened) Depression feelings Brain fog and memory issues Physical changes: Weight gain (especially belly fat) Difficulty losing weight Muscle loss Joint aches and pains Headaches or migraines Breast tenderness Sleep disruption: Insomnia (can't fall asleep) Night waking (can't stay asleep) Night sweats wake you up Unrefreshing sleep Daytime fatigue Sexual and urogenital: Low libido (loss of interest) Vaginal dryness Painful sex Urinary changes Energy and metabolism: Crushing fatigue Exercise doesn't work like before Slower metabolism Blood sugar issues developing Thyroid-like symptoms See our peptides for menopause guide for the next phase and peptides for women over 40 for comprehensive women's protocols