Clinical Research Directory

Inclusion Criteria: * Biological females in early and late perimenopause. Menopausal stage will be defined according to the Stages of Reproductive Aging Workshop +10 (STRAW+10). According to STRAW+10, perimenopause is characterized by menstrual cycle irregularity, specifically defined as having bleeding in the previous 12 months but at least a 7-day difference from usual menstrual cycle length * Experiencing menopause symptoms (e.g., hot flashes, night sweats, joint stiffness) * Aged 40 years or older * Multiple risk factors for cardiometabolic disease, namely being sedentary (\<30 min of moderate-vigorous physical activity/week), having a BMI ≥25 kg/m2, and a waist circumference indicative of abdominal obesity, specific to BMI (e.g., BMI 25-29.9: WC: 90cm; BMI 30-34.9: WC: 105cm; BMI 35-35.9: WC:115cm). Exclusion Criteria: * History of reproductive surgeries including oophorectomy, hysterectomy, ablation or gender-affirming. * Diagnosis of cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease, cancer (except for non-melanoma skin cancer), respiratory disease (e.g., Chronic Obstructive Pulmonary Disease or severe or uncontrolled asthma), uncontrolled hyper- or hypogonadism (change in medication or dosage in last 6 months and with major symptoms), and/or Polycystic Ovary Syndrome * Major signs or symptoms (regardless of known diagnosis) of cardiovascular diseases, diabetes, or renal disease * The use of medication that could impact blood glucose * Pregnant or post-partum \<12 months, lactating or breast feeding within 3 months of the start of study * Recreational smoking (e.g., tobacco, smoking) * Actively engaging in a low-carbohydrate diet (e.g., ketogenic, Atkins) * Using transdermal hormones, taking exogenous hormones, or receiving exogenous hormones from other means (e.g., intrauterine device) * Significant weight loss (i.e., \>5 kg) in past 3 months or currently taking weight loss medications