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Because perimenopause accelerates the age-related decline in GH pulse amplitude, sermorelin restores endogenous GH release through the intact hypothalamic-pituitary feedback loop rather than bypassing it, preserving the body's own regulatory checks on GH output

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It has been reported that exercise or restriction of energy intake enhances skeletal muscle mitochondrial levels and oxidase activity, reduces body weight, and improves insulin sensitivity in patients with obesity and diabetes (50)