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This interval, called perimenopause, is the adaptive reproductive phase, where there begin to be inconsistent oscillations in ovarian estrogen production as the follicles respond to gonadotrophin waves of follicle-stimulating hormone (FSH) [10]

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Endothelial homeostasis becomes unbalanced as a result of AGEs binding to RAGE in endothelial cells, which increases mitogen-activated protein kinase (MAPK) and enhances the production of lysyl oxidase and ET-1 under the control of nuclear factor kappa B (NF-B) and activator protein-1 (AP-1) [35]

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