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The key to success in such cases is managing patient behavior

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Consequently, nicotine reduces circulating estrogen levels and leads to early onset of menopause in women. In plain speak, this means smoking not only makes your estrogen levels fall faster than a non-smokers menopausal estrogen experience, but it also brings on menopause sooner

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Secondly, the study sample was not randomized, and the two groups of subjects were not matched based on gender and age