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Menopausal status is often missing in pharmacovigilance datasets and many trial summaries, yet it is a dominant effect modifier for vaginal symptoms via GSM

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The FDA has flagged concerns about thyroid tumors, including medullary thyroid carcinoma (MTC), based on animal studies, though the risk to humans isnt fully understood

Some women also report improvements in energy levels and mental clarity, though these effects may be indirect results of better metabolic control and weight management