Letter to the reader

Introduction: Let's begin

Part one: You are here. The status quo experience in perimenopause ; The zone of chaos ; The troubling patterns of misdiagnosis (and gaslighting)

Part two: A window of vulnerability. This is your brain on perimenopause ; The mental health changes you may notice ; Strange cognition: the rise of brain fog and ADHD-like symptoms ; Perimenopause and metabolic syndrome ; Osteoporosis: the debilitating bone disease that starts sooner than you think ; Sarcopenia: the muscle loss no one warned you about ; Dreaming of sleep in perimenopause

Part three: Sex, pregnancy, and periods in perimenopause. When desire shifts: perimenopause and sexual function ; Fertility changes and challenges: the clock is real, but so is your power ; When the bleeding becomes a mystery: uterine changes in perimenopause

Part four: A window of opportunity (for prevention). Treating hormonal fluctuation with hormones: a deep dive into MHT to treat perimenopause ; The foundation for resilience: the lifestyle factors that matter most ; Talking points and lab tests: everything you need for your next appointment

Conclusion: What I wish I'd known at thirty-five

Acknowledgments

Appendix A: Selected resources

Appendix B: The new perimenopause five-day meal plan.