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As a result, BHRT is a safe and effective way to alleviate perimenopausal symptoms

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Melanocortins are a family of neuromodulatory peptides derived from the polypeptide, pro-opiomelanocortin (POMC), by tissue-specific cleavage 31, 32 through the action of prohormone convertases 31

, even in those with low testosterone levels, due to its suppressive effect on the HPG axis

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Importantly, this inhibition occurred without bactericidal effects on gut microbiota, as confirmed by preserved alpha diversity and the persistence of TMA-producing genera such as Collinsella and Clostridium post-treatment