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doi: 10.1038/s41419-018-0295-5 9 OliynykGRuiz-PrezMVSainero-AlcoladoLDzieranJZirathHGallart-AyalaHet al

Many women notice changes such as: Slower metabolism and increased fat storage, especially around the belly and hips Changes in insulin sensitivity and blood sugar regulation Shifts in hunger and fullness signals Hormone fluctuations in perimenopause can trigger fat-storage mechanisms, reduce lean muscle mass, and make traditional diet and exercise feel less effective

doi: 10.1124/pharmrev.123.001087 117 HalawiHCamilleriMAcostaAVazquez-RoqueMOduyeboIBurtonDet al

Cramp frequency and severity were higher in females of the present study, consistent with previous studies [3, 14, 15]