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A consensus of the literature suggests that when there is a dysfunction in the brain reward cascade, especially in the dopamine system, causing a low or hypo-dopaminergic trait, the brain may require dopamine individuals to avoid unpleasant feelings (8, 9)

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An individualized approach is needed for the commencement and continuation of HRT, and discussions between healthcare practitioners and each woman should take into account their personal benefit vs risk profile to aid shared decision-making