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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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