Hello, You have gained weight, have low energy level, shortness of breath, ankle swelling, constipation and hot flashes. You have normal menstruation. You are in peri menopausal phase, a transitional period before menopause. During this period you may experience hot flashes and other symptoms as the level of estrogen decreases. You may start to experience menopause-like symptoms, such as hot flashes or irregular periods, weight gain, etc. Weight gain, anemia, sedentary lifestyle, thyroid dysfunction, URTI, stress, etc., may trigger shortness of breath. You are suggested to do regular walking in the morning and evening and maintain healthy weight. Swelling of the ankle is commonly due to water retention, obesity, chronic venous insufficiency, heart problems, kidney problems, etc. You should limit the amount of salt or salty food(snacks) intake. Avoid sedentary lifestyle. Get a complete medical check up done with lipid profile,T3, T4, TSH, etc. Get treated at the earliest. Take laxatives and increase fiber in your diet to prevent constipation. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician