Women enter perimenopause between the ages of 45-55 years, with the average age of menopause being 49 years. During perimenopause, due to the decline of ovarian function, menstrual disorders occur, manifested by changes in the menstrual cycle, menstrual period, and menstrual volume (most patients show a decrease in menstrual volume). In addition, symptoms associated with decreased estrogen appear: 1. impaired thermoregulation, hot flashes during the day and night sweats, appearing on the face and neck, front and back of the chest, lasting <1 to 3 minutes, lasting 1 to 5 years. 2, mental and emotional changes: irritability, irritability, depression, inability to self-control, insomnia and dreaminess, memory loss, inattention. 3. Genitourinary tract changes, vaginal dryness, pain, difficulty in intercourse, recurrent vaginitis, urethritis, cystitis, frequent urination, frequent night urination and urge incontinence, etc. 4, sleep disorders, insomnia is one of the signs of aging in women, 48% of menopausal women have insomnia. 5, depression. The incidence of perimenopause 23.8%, depression is the main cause of suicide. 6. Osteoporosis, cardiovascular disease, atherosclerosis, and Alzheimer's disease can occur after the age of 50. Hormone replacement therapy (HRT) can effectively relieve menopausal syndrome and menstrual disorders, prevent and treat postmenopausal osteoporosis, and help prevent memory loss and Alzheimer's disease. HRT can be used for perimenopausal and postmenopausal women of any age, provided that there are indications for HRT and no contraindications, but hormone supplementation is most effective when started during the "window" of menopausal transition. The main side effects of HRT may increase the risk of breast cancer, cardiovascular disease (including stroke and heart attack), venous thrombosis, and cholecystitis, and estrogen alone may increase the risk of endometrial cancer. What is important to know is that we should not abandon treatment and take greater risks of disease because we are afraid of the possible risks of hormone supplementation therapy. Just as one should not be afraid to leave the house for fear of a car accident. The International Menopause Society states that for healthy women aged 50 to 59, hormone supplementation does not increase the risk of coronary heart disease and may even decrease it. And breast cancer risk is rare, occurring at the same rate as a car accident. Long-term estrogen supplementation alone (7 and 15 years, respectively) does not increase the risk of breast cancer. Before HRT, gynecological examination of breast and pelvic ultrasound, examination of liver and kidney function, blood lipids, blood sugar, coagulation factors, blood and urine routine, hormone levels, etc., bone density check if available, and regular review (six months to one year, shorter if appropriate if there are problems) must be performed. For women who have had a hysterectomy, estrogen alone is used. Women with a uterus are treated with sequential estrogen and progestin. A good lifestyle is equally important. Advocate a healthy diet, vegetables, fruits, roughage, low-fat foods, fish, lean meat; reduce salt intake; control weight; moderate exercise.