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This three-lever approach has two practical consequences

Elevated estrogen has predictable effects on the menstrual cycle: Proliferative phase lengthens (uterine lining thickens more than usual) Breakthrough bleeding occurs if estrogen drops suddenly after a surge Next period may be heavier because the lining is thicker Estrogen can delay ovulation, shortening the luteal phase The phenomenon is well-documented in bariatric surgery literature

In people with poorly controlled diabetes, yeast infections are a common issue because their high blood sugar levels provide more fuel for yeast

However, these side effects were mild and didnt cause anyone to stop treatment