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These declining hormone levels can also cause other telltale signs of perimenopause, such as: Hot flashes or night sweats Trouble sleeping or daytime fatigue Forgetfulness or brain fog Vaginal dryness Pain or discomfort during sex Mood changes, such as increased anxiety or irritability Reduced bladder control or an increase in urinary tract infections (UTIs) Pregnancy and Birth Control If youve recently started birth control, that could be affecting your cycle regularity or bleeding

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