Menopausal Hormone Therapy And Left Ventricular Function

Inclusion Criteria • \>45-60\< years of age Exclusion Criteria * Male sex * Females between STRAW+10 stages -5 and 0 * PMF in STRAW+10 stage +2 * PMF using oral hormone therapy * Females who entered menopause due to a surgical procedure or in response to pharmacotherapy (e.g., gonadotrophin releasing hormone agonists or chemotherapy) * Heart disease such as hypertropic cardiomyopathy, congenital abnormalities, chronic heart failure, valve disease, and a history of myocardial infarction * Medications that impact the central nervous system including selective serotonin reuptake inhibitors, anxiolytics, sedatives, anticholinergic agents, dopamine, amphetamines, or wake-promoting agents (e.g., modafinil). Other medications will be evaluated on an individual basis by the PI. * Cardiovascular medications is also an exclusion criterion which includes those acting on the renin-angiotensin-aldosterone axis, adrenergic receptor antagonists, diuretics, nitrates, and calcium channel antagonists. Other medications will be evaluated on an individual basis by the PI. * Pregnancy * COPD * Diabetes * CKD * Raynaud's phenomenon * Sleep disorders * Shift workers * BMI ≥40.0kg/m2 * Use of nicotine-containing products within the two years preceding study visits * Active cancer treatment