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Hot flashes and night sweats Experienced by up to 80% of menopausal women, caused by estrogen withdrawal affecting the hypothalamic thermoregulatory center Sleep disruption Difficulty falling asleep, frequent waking, non-restorative sleep, often compounded by night sweats Mood changes Increased anxiety, irritability, depressive episodes linked to fluctuating estrogen and declining progesterone Low libido Declining testosterone and estrogen reduce sexual desire, arousal, and satisfaction Brain fog and memory difficulties Estrogen supports neurotransmitter function and cerebral blood flow