Perimenopause is clinically defined as a midlife transition state that leads to reproductive senescence in women 1,2 but, functionally, its symptoms are largely neurological in nature 3 (ie, depression, insomnia, mood changes, cognitive dysfunction, anxiety and aggressive behaviour). Worldwide, approximately 1 billion women are aged 40-60 years (United States Census Bureau, 2014) and 88% of this population will transit through perimenopause at an average age of 51.4 years. 4 Thus, all women, regardless of ethnicity, geographical location or culture, who reach the age of 60 years with their reproductive organs intact will transit from active reproductive life through perimenopause to menopause within 1-5 years. 5,6
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