When estrogen, progesterone and testosterone begin to decline in the 30’s, subtle symptoms can include irregular, heavier, or lighter periods, fatigue, weight gain, bloating, breast tenderness, depression, irritability, anxiety, worsening PMS, acne, and low libido. These symptoms may or may not be associated with perimenopause or the menopausal transition but if persistent and disruptive, seeing a healthcare provider may be helpful.