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The interplay of estrogen levels and the mesolimbic reward system in some women can be disrupted, potentially causing psychiatric conditions, including anhedonia or psychosis. The Perimenopausal Effects of Estradiol on Anhedonia and Psychosis Study (PEEPs) employs a mechanistic clinical trial design, seeking to link perimenopausal anhedonia and psychosis with specific neuro-molecular markers of mesolimbic reward response, and additionally to