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This pathway becomes particularly relevant after menopause, when ovarian estrogen production declines and adrenal precursors become the main substrates for local steroid synthesis [216]

In the downregulated DEPs, the annotation identified neural or synapse-related functions as the primarily affected terms, including synaptic vesicle (SV) membrane, exocytic vesicle membrane, SV, and myelin sheath (CC)

Where coverage exists, prior authorization is expected with standard BMI criteria (BMI 30 or higher, or BMI 27 or higher with a weight-related comorbidity) and a documented lifestyle program

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Safety begins before the appointment with a structured patient intake, followed by physician review for eligibility and protocol selection, and a final on-site nurse assessment including vital signs