Hepatic fibrosis is characterised by the accumulation of the extracellular matrix (ECM)a network of macromolecular proteins that under normal physiological conditions maintains tissue homeostasis, but in excess leads to fibrosis [38]
The profound hormonal shifts of perimenopause and menopause contribute to metabolic slowdown and weight gain, which can be directly addressed by these medications
A thorough assessment should include review of other medications (antidepressants, antihypertensives, and hormonal contraceptives commonly affect sexual function), evaluation for mood disorders including depression and anxiety, assessment of relationship factors and psychosocial stressors, and consideration of underlying medical conditions such as thyroid dysfunction, diabetes complications, or cardiovascular disease
Clinical Category Guidance & Safety Mandates Thyroid History Warning Strictly contraindicated if you or any family members have a history of Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Key Takeaway: The 28-day rule typically refers to the window of safety once a vial has been punctured, while the Beyond-Use Date (BUD) refers to the overall shelf life of the unopened product
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