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Instead, they're bouncing around like ping-pong balls, and all that hormonal chaos triggers the classic perimenopause symptoms: irregular periods that show up whenever they feel like it, hot flashes that make you feel like you're spontaneously combusting, night sweats that turn your bed into a swamp, mood shifts worthy of an Oscar, sleep that becomes more elusive than a unicorn, and libido and arousal changes that nobody warned you about

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A common pattern involves using higher doses (2mg daily) during the first cycle, then transitioning to maintenance doses (1mg 2-3x weekly) for subsequent cycles