Syra Hanif and our expert team at Manhattan Medical Arts are here to guide you through the process and help you feel your best, inside and out

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
Its unusual stability and demonstrated biological activity in laboratory models make it a valuable tool for mechanistic studies
Longevity and mitochondrial work draws on Epitalon (a four-residue telomerase modulator in pre-clinical studies)

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By supporting this energetic signaling, the body can more easily return to a state of balance and regeneration