This is often a major decade of transition for women. These years may be easy and asymptomatic with no hormonal fluctuations, or these years may manifest in wide swings in hormones, with menstrual changes, mood, weight, and libido issues. We clearly recognize the perimenopause and the impact its changes can have on everyday functioning. Returning life to a place of stability is an area of concentration and specialty in our practice. This is truly a time when no two women fall into the same symptomatic place and where the counseling and treatment is specifically tailored to fit each woman’s needs.