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You should contact your GP if you experience: Absence of periods for three consecutive cycles (amenorrhoea) if you previously had regular menstruation Unusually heavy bleeding (soaking through a pad or tampon every hour for several consecutive hours) or passing large clots Bleeding between periods or after intercourse, which requires investigation regardless of medication use Severe pelvic pain that differs from typical menstrual cramping Symptoms of anaemia including persistent fatigue, breathlessness, palpitations, or pallor Seek urgent medical help via NHS 111 or A&E for very heavy bleeding with dizziness or fainting, or severe abdominal pain that could indicate complications such as pancreatitis

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Changes in blood pressure, BMI, and lipid fractions did not reach statistical significance across interventions, suggesting that glucose and weight benefits did not yet translate into short-term shifts in these cardiovascular parameters

Presented for research literature review only Janes W et al