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Larger prospective trials, stratified by hormone formulation, route of delivery, timing of initiation, and baseline metabolic health, will be required to establish causality, characterize which women benefit most, and track outcomes across the full range of health domains this article has examined

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Continuous outcomes were analyzed using ANCOVA, with randomized treatment as a factor and baseline body weight as a covariate, while categorical data were analyzed with binary logistic regression

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