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The cultural shift toward recognizing and treating perimenopausedriven by patient advocacy, social media, and high-profile coveragemeans women are presenting earlier, often in their late 30s and early 40s, with irregular cycles, vasomotor symptoms, sleep disruption, and mood changes

In some patients, this response becomes exaggerated, leading to rapid heart rate, internal shaking, overstimulation, and a persistent sense of being on edge. In some cases, this pattern may reflect hyperadrenergic POTS , a subtype characterized by increased sympathetic activity

Genetics of coenzyme q10 deficiency

L., Park, M., Murphy, K