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Perimenopause is far more than a collection of symptoms to manage — it is a critical window of opportunity to protect long-term cardiovascular, skeletal, and cognitive health. The hormonal fluctuations of this transition are directly linked to cardiovascular risk, making proactive action during perimenopause one of the most important investments a woman can make in her future health. This article outlines a practical three-step perimenopausal game plan covering hormone replacement, resistance training, and time-restricted eating — grounded in current research and designed to build the physiological reserves needed for a healthy postmenopause.