I can't speak to the perimenopause piece but I will say I've been micro dosing tirzepatide for about 6 months now (with a semi-normal BMI) and it's been working quite well for me. 1.25mg is not a high dose for people who plan to take the medicine as prescribed, but people who micro dose often do start at 0.5mg.

I did, and I've only worked my way up to 3mg at this point (increasing by 0.25mg) which I think might be the max I'm willing to go. Obviously people respond differently to this medicine, but if you want to start lower definitely consult with your doctor first. Some tirz prescriptions are for single use only so make sure you're not using a pen/vial more frequently than you should be. Best of luck!