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Large randomized trial meta-analyses in humans have not confirmed a statistically significant increase in MTC, though pharmacovigilance signals exist and the question is not fully settled

10.1001/jama.292.4.490 13 LindamoodC

Obesity lowers testosterone through several mechanisms, including increased conversion to estrogen in fat tissue

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Most individuals develop competence and confidence with injection technique within 2-3 administrations, with initial apprehension giving way to routine as the process becomes familiar