The multisystem impact of perimenopausal hormonal fluctuations on chronic disease risk.

Hormonal shifts during menopause are crucial to women's health, characterized by a reduction in estrogen levels and an elevation in circulating androgen, which may result from either natural or surgical menopause. This review synthesizes current knowledge on the multifaceted mechanisms by which menopausal hormonal fluctuations reshape systemic health span. This review synthesizes current knowledge of the complex mechanisms between hormonal changes and immune cell interactions, highlighting how these relationships can influence disease risk during the menopausal transition. We also emphasize how these neuroendocrine-immune-microbial disruptions facilitate the pathogenesis of neurodegenerative disorders, cardiovascular diseases, osteoporosis and the evolution of tumorigenic microenvironments. Finally, we discuss key challenges and future research directions in related research with goal of informing novel strategies to prevent and treat menopause-related diseases.