Lilly R. began having night sweats, joint pain, dry skin, hair loss, and an intolerance to red wine at 39, followed by years of insomnia and a diagnosis of functional depression. At 43, she rapidly gained 10 pounds, and her cholesterol, triglycerides, and blood glucose became concerning. Her gynecologist dismissed her concerns, saying that “Latina women” do not enter perimenopause until 49. When Lilly pushed for hormone testing, she was told that everything was normal. A menopause specialist later prescribed hormone therapy. Within six months, Lilly felt like herself again. She reflects that menopause is rarely discussed in the Hispanic community and that clinicians must stop dismissing women’s experiences.

Haver positions perimenopause as a time to protect long-term health rather than simply endure symptoms. Research is sparse and often extrapolated from non-perimenopausal models, and medical training has historically emphasized treating symptoms in isolation rather than the underlying hormonal instability. Treatment is individualized and often iterative.

Hormones act as chemical messengers; when levels fluctuate, cellular communication falters. A proposed term, PET hormones (progesterone, estrogen, testosterone), better reflects broader use than MHT. Estradiol is the most potent estrogen and swings widely in perimenopause, estrone dominates post-menopause, and estriol is largely a pregnancy hormone. Progesterone supports sleep and