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Timing considerations If starting both HRT and peptides: Start HRT first (if using) Establish HRT dose over 1-2 months Add peptides once HRT stable Easier to assess effects If already on HRT: Add peptides to existing HRT Monitor symptoms May be able to reduce HRT doses eventually Work with prescribing physician Transitioning off HRT: Establish peptide protocol first Gradually reduce HRT Monitor symptoms carefully Not recommended to stop HRT abruptly Lifestyle optimization for perimenopause with peptides Peptides work best with solid fundamentals

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Table 3 also showed the results of the previous cycle and the subsequent cycle for 362 controls, without any adjuvant medication

Moreover, SGLT2 inhibitors promote weight loss in many individuals and decrease the risk of major cardiovascular events