Perimenopause is not just about hormones, it’s a metabolic transition that affects insulin sensitivity, gut health, stress tolerance, and long-term disease risk. In this episode, Cynthia Thurlow, board-certified nurse practitioner and functional medicine expert, explains how women’s metabolism changes in midlife and why insulin resistance, poor stress resilience, and gut dysfunction often appear years before menopause. She breaks down how perimenopause can begin earlier than most women expect, why symptoms vary so widely, and how lifestyle factors like fasting, exercise intensity, sleep, alcohol, and chronic stress interact with hormones during this transition. Join the most comprehensive *female-specific community for health and longevity optimization.* After over a decade dedicated to human performance and women’s health, I created this space to share everything you need to know to optimize health and lifespan.