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184,185 The pathophysiology of DRPN involves ischemic injury due to microvasculitis leading to nerve fiber ischemia and immune-mediated mechanisms, as evidenced by inflammatory infiltrates in nerve biopsies

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Hormone Replacement Therapy (HRT): The Stepwise Method Instead of jumping into full hormone replacement, McCall recommends a phased approach: Prioritize Based on Symptoms: Progesterone: For anxiety, insomnia, heavy periods, mood swings Testosterone: For low libido, energy issues, muscle loss Estrogen: Last to drop, often during peri/menopause Action Plan: Begin with the hormone causing the most distress