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They also stimulate type I collagen production and elastic fiber synthesis through the transforming growth factor-beta/Smad pathway, further enhancing skin firmness and elasticity

These shifts happen because hormone levels begin to fluctuate in a less predictable way, making cycles less consistent than they once were

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Age at index was defined by TriNetX as the age on the index date, and the 18-year filter was applied at cohort creation

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