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Side Effects: Side effects are uncommon but may include pain at the injection site, nausea, and fatigue/dizziness

While reducing androgen levels limits hormone production, spironolactone also acts directly to protect hair follicles from DHT damage

More energized than with previous providers and very happy to see my muscles are still here So easy

At that level, someone who began the trial wearing size 38 pants might finish wearing size 32 or smaller

These rashes can occur at the injection site or spread to other parts of the body

Secondary Outcome: Secondary Outcomes: Changes in waist circumference, body fat, body lean mass, and metabolic risk factors including levels of plasma glucose, insulin sensitivity, serum lipids, and blood pressure Statistical Analysis Full details previously published 2 and can also be found in the STEP group statistical analysis plan at NEJM.org Statistical analysis approach sought strong control for type I error All endpoints addressing intervention efficacy were analyzed using intention-to-treat approach All endpoints addressing intervention safety were analyzed using per-protocol approach Efficacy endpoints analyzed using 2 estimands Treatment Policy Estimand: intention to treat analysis