Perimenopause can cause real shortness of breath and air hunger. Falling estrogen and erratic progesterone affect airway tone, lung tissue, and the brain's breathing control center, while anxiety, iron loss from heavier periods, and disrupted sleep breathing often add to it. Cathy breaks down what peer-reviewed research actually shows, what helped in her own tracking, and the red flags that mean it's time to call a doctor rather than wait it out.