Menopause Transition marks the period of changes from normal ovulatory function to cessation of menses and some immediate period thereafter. It falls in −2 and −1 Straw Staging. It is subdivided into Early and Late Menopause Transition. Menopause Transition itself is proinflammatory and disrupts estrogen-regulated neurological system. It prompts an innate immune inflammatory response in female reproductive organs that propagate to the brain. Low estrogen leads to upregulation of neurokinin B in the preoptic area, which acts on hypothalamic neurokinin 3 receptor, precipitating inappropriate hot and cold sensation. There are higher levels of circulating interleukins also. Symptoms of Menopause Transition include menstrual problems, cardiac, vasomotor, genitourinary, sleep problems, cognitive and mood symptoms, sexual, somatic, musculoskeletal, and skin problems. There is increased FSH, LH, and decreased estradiol, AMH, inhibin, DHEA, testosterone. Management involves Lifestyle changes including exercise, avoiding smoking, balanced diet, proper sleep, nutritional supplements, Lycopenes, and Isoflavones. Medications include MHT, Ospemifene, Vaginal Lubricants, moisturizer, SSRI, SNRI, and Gabapentine. An overall positive attitude, mindset, and strong resilience help to sail well through Menopause Transition.