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Common signs that it may be time to discuss HRT include: hot flashes or night sweats that disrupt sleep or leave you exhausted during the day vaginal dryness, pain during sex, or urinary symptomssometimes called the genitourinary syndrome of menopause (GSM)that affect comfort and intimacy sleep problems, fatigue, or brain fog that seem connected to other menopause symptoms mood changes, including irritability or anger, that seem tied to hormonal shifts irregular or skipped periods before age 45, which may suggest early menopause and should be evaluated These are reasons to discuss HRT, though it isn't always the best fit for everyone

Fonseca AC, Scott Summers R, Hernandez MT (2001) Comparative measurements of microbial activity in drinking water biofilters

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A fast jump can overwhelm the nausea pathway before the brake develops. Slowing down later did not erase the difference

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