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Progesterone-Only Therapy: When Estrogen Isn't the Problem For women in early perimenopause with evidence of estrogen dominance (high or normal estradiol, anovulatory cycles, symptoms of progesterone deficiency), oral micronized progesterone (OMP) alone may be the most appropriate treatment [8,18]

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This is not a set-it-and-forget-it transition it requires close monitoring and ideally a care team experienced in adjusting insulin regimens

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There can even be an issue of stimulating mold to make more mycotoxins