Treatment of Menopause Premarin

Menopause can cause uncomfortable symptoms and associated age-related issues. To address these, hormone replacement therapy (HRT) can be a successful solution, particularly when easing the intensity of hot flashes. An HRT option, called Premarin, contains conjugated estrogens – a form of the hormone estrogen.

If you have any questions about the drug Premarin, this section can provide some helpful answers. However, do keep in mind it isn’t a comprehensive source – to gain an in-depth knowledge it’s always best to speak with your physician or pharmacist. It’s essential to understand that all medications carry pros and cons. Your doctor has taken into account your individual circumstances when deciding whether or not to prescribe Premarin.

Before You Take Premarin

Considering the health risks associated with taking Premarin, it is important to be informed on what using this medication may entail. As certain groups may be at an even higher risk for developing adverse issues, here are some essential points to take into consideration before deciding to use Premarin.

Allergies and Inactive Ingredients

It is always important to consult with your healthcare provider prior to taking any medication, especially if you have any known allergies. Additionally, this drug contains other inactive ingredients that may lead to unwanted allergic reactions or other health issues. Therefore, it is highly advisable to discuss this with your doctor or pharmacist before usage.

Medical History

Make sure to let your doctor or pharmacist know about any past health issues, particularly if you have endured the following:

  • Vaginal bleeding of unknown cause
  • Certain cancers (such as breast, uterus, or ovarian cancer)
  • Blood clots
  • Stroke
  • Heart disease (including heart attack)
  • Liver or kidney disease
  • A family history of breast lumps, cancer, or blood clots
  • A personal or family history of angioedema (a swelling disorder)
  • Blood clotting disorders (high blood pressure or porphyria)
  • Diabetes
  • High cholesterol/triglyceride levels
  • Obesity
  • Lupus
  • Mineral imbalances
  • Hypoparathyroidism (a hormone problem)
  • Uterus problems (such as fibroids or endometriosis)
  • Gallbladder disease
  • Asthma
  • Migraine headaches

Avoid Smoking

Women aged 35 and over need to bear in mind the potential risks associated with smoking or consuming tobacco while consuming estrogen, such as the heightened chance of stroke, blood clots, hypertension, and heart attack. Acknowledging the dangerous side effects of smoking combined with estrogen intake is critical.

Pregnancy and Breastfeeding

If you’re expecting, or think there’s a possibility of pregnancy, it’s critical to alert your physician immediately. Pregnant women should absolutely not take Premarin.

Nursing moms should talk to their doctor for tailored advice on breastfeeding while taking this medication as it can influence the amount and quality of breastmilk produced. Taking the time to get individualized guidance will be beneficial in the long run.

Side Effects of Premarin

Whenever you take medication, it’s beneficial to take into account both positive and negative consequences. It may be helpful, but there may also be unexpected adverse reactions. If any of the following signs occur, it is urgent to contact your physician immediately:

  • Severe allergic reaction: Signs include a rash, intense itchiness, swelling of the lips or tongue, difficulty breathing, abdominal pain, or nausea and vomiting.
  • Heart attack: Whether it’s chest pain, shortness of breath, perspiration, nausea, or pain radiating to the shoulder, arm, neck, or jaw, all of these could be warning signs of a heart attack.
  • Stroke: Sudden changes in speech, loss of coordination or balance, numbness on one side of the body or face, severe headaches, vertigo, or confusion.
  • Blood clot: Be mindful of the possible signs and symptoms of a blood clot, which can include chest pain, difficulty breathing, dizziness, accelerated cardiac rate, swelling, and discomfort or discoloration of your arms or legs.
  • Cancer: Remain aware for any lumps, aching, inflammation, or modifications in the chest area, enlarged lymph nodes, strange or intense vaginal bleeding, swollenness, extraordinary lethargy, or abdominal soreness.

Note: As your body acclimates to the new medication, some of the side effects may become less intense. Nevertheless, if the symptoms remain or get worse, talk to your doctor without delay.

Tablets

  • Headache (10-15%)
  • Bleeding outside a normal menstrual cycle (2-14%)
  • Breast pain (6-12%)
  • Stomach pain (7-13%)
  • Passing gas (5-7%)

Vaginal cream

  • Breast pain (2-6%)
  • Headache (3-5%)
  • Pelvic pain (2%)
  • Vaginal discharge (1-4%)

People who have taken the medication may suffer from further adverse effects such as feeling nauseated, aching back, feeling itchy, being unable to sleep peacefully, having discomfort in the vagina and experiencing vaginal yeast infection.

Typical Dosage for Premarin

Complying with the medical professional’s or pharmacist’s directions are essential, as they may differ from what is printed in this part. If you’re having trouble understanding the information indicated on the packaging, ask for help without delay.

Note: Premarin can be taken regardless of meals.

Tablets

  • Menopausal symptoms – The starting dose is 0.3 mg taken orally, administered on a daily basis.
  • Low estrogen – The starting dose may vary from 0.3 mg to 1.25 mg when taken daily for three weeks. After this period, you will have one week of taking no tablets before starting the cycle again.
  • Breast cancer – The credible dosage consists of 10 mg administered orally three times daily for at least three months.
  • Prostate cancer – The dose is 1.25 mg to 2.5 mg taken orally three times a day.
  • Prevention of bone loss (osteoporosis) – The recommended dosage for optimal results is 0.3 mg taken orally once daily.

Vaginal Cream

  • Vaginal thinning unrelated to menopause Use the applicator 0.5 grams of cream into the vagina once a day for three consecutive weeks, followed by one week of rest. Repeat this routine regularly.
  • Vaginal dryness and irritation due to menopause Try using the provided applicator to insert a 0.5 gram dose of cream vaginally twice a week. This can be an effective treatment to relieve these symptoms.

Also, Premarin is also available as an injectable that can be used to tackle abnormalities in uterine bleeding caused by hormone incongruencies.

Premarin & Other Medications

Medicating wisely is vital for good health and wellbeing. Whether it’s Premarin or another medication, understanding how to take the right dosages at the correct times is key for positive results. Knowing the potential risks and benefits of using these drugs can help lead towards a healthier lifestyle.  Thinking carefully about the individual advantages of each medication, and ensuring you are aware of any possible side-effects is also of great importance. Taking quality care when it comes to deciding which medication is right for you is always worthwhile in the long-run.

When starting to take Premarin, it’s important to keep your physician and pharmacist informed of any other drugs or supplements you may be taking. This includes prescription or non-prescription drugs, vitamins, dietary supplements, and any herbal remedies. The following includes some common medications by their generic names, but it’s not a comprehensive list for potential interactions with Premarin.

  • Dasabuvir
  • Ombitasvir
  • Paritaprevir
  • Ritonavir
  • Tranexamic Acid

Taking certain medications in tandem with others of the same class is not typically advisable. If your physician believes it prudent, they may decide against prescribing any pharmaceuticals in that class, or adjust the other medications you’re currently taking.

Advantages and Disadvantages of Premarin

Advantages:

  • Available in tablet and vaginal cream formulations
  • Effectively alleviates various menopausal symptoms
  • Tablets can address low estrogen conditions, bone loss, and cancer-related pain
  • Tablets are offered in multiple strengths, facilitating personalized dosage adjustments
  • Vaginal cream can be used for both menopause-related and non-menopause-related vaginal symptoms

Disadvantages:

  • Heightened risk of specific cancers, blood clots, and strokes
  • Some individuals may require concomitant use of another hormone called progestin
  • Not the preferred initial choice for treating postmenopausal bone loss
  • Symptom improvement may take several weeks
  • Available solely as a brand-name product, potentially leading to higher costs

The Influence of Menopause on the State of Health

For certain women, menopause – a period marking the end of menstrual cycles for 12 continuous months – may come as an expected change at the age of 51. Usually lasting about seven years, the transition may extend beyond that time frame in some cases.

Later life usually brings about various physical transformations, many of which are associated with menopause and include cessation of periods. A few of these effects may be quite uncomfortable, like hot flashes, while others might go unnoticed.

Below you can get a deeper grasp of the physical and mental implications of menopause and some regularly experienced symptoms.

Common Signs of Menopause

Here are some common signs to watch out for:

  • Mood fluctuations: As women go through menopause, their emotions often swing from joy to discontentment and even melancholy.
  • Insomnia: Experts attribute nighttime insomnia to a decrease in estrogen levels, which disrupts your regular sleep routine.
  • Cessation of periods: Since menopause arrives when your monthly cycle has come to an end, you no longer experience any of the associated symptoms that accompany your period. This usually includes an absence of spotting.
  • Painful intercourse: Women who still experience a craving for intimacy may nonetheless feel discomfort during intercourse. Intercourse may be a painful ordeal for some.
  • Reduced sex drive: Estrogen levels decline with age and this can lead to uncomfortable side effects such as vaginal dryness and low sex drive.
  • Vaginal dryness: As your changing hormones lead to a shift in reproductive phase, your body reduces the production level of natural lubricant, thereby causing vaginal dryness.
  • Bone fractures: As part of the menopausal process, bone density may decrease, resulting in an elevated risk of broken bones. It is vital to be aware of this increased fragility and take the necessary steps to reduce the odds of sustaining a fracture.
  • Hot flashes: Sudden spikes in body temperature can cause flushed skin and redness anytime, anywhere.
  • Night sweats: Excessive perspiration during sleep, often accompanying hot flashes, can leave you waking up drenched in sweat.
  • Weight gain: An imbalance in hormones may lead to the body’s decreased ability to eliminate fat, thus creating an accumulation of extra pounds.
  • Frequent urination: Estrogen imbalance and fluctuations in this hormone can lead to more frequent trips to the bathroom.

By understanding how menopausal transition affects the body and mind, we can better identify and categorize the associated signs and symptoms. This improved understanding empowers us to tackle these oftentimes challenging changes.

Effects of Menopause on the Physical State of Health

A woman’s reproductive health depends heavily on estrogen and progesterone. Aging can result in anovulation and irregular menstrual cycles due to dysfunction of the ovaries.

As time passes, the ovaries stop the process of ovulation faithfully. Eventually, this leads to the final cessation of regular menstrual cycles. Subsequently, the result is a significant decline in estrogen and progesterone secretion by the ovaries.

Menopause officially sets in after a woman experiences one-year missed periods, typically within the age group of mid-40s to mid-50s. The transition can take several years to complete.

Menopause marks the termination of child-bearing prospects. However, it’s not just the drop in estrogen levels that brings about change – it can spark bodily side effects too.

Reproductive System

The onset of menopause is signaled by perimenopause, a journey marked by change in your monthly cycle. While the early stages are prominent, true menopause is only achieved when your periods stop completely, signifying the end of egg production for conception.

Women who no longer experience shedding of unfertilized eggs no longer go through the physiological process of menstruation.

Menopause affects much more than the menstrual cycle. There is an absence of thickening cervical mucus, which is typically a sign of ovulation.

The onset of menopause can cause noticeable changes in the body, including vaginal dryness and a lack of sexual desire. However, these effects do not have to be permanent, as making use of certain over-the-counter products can help to alleviate symptoms.

For women dealing with a decrease in sex drive during menopause, speaking with an OB-GYN can greatly assist in finding ways to boost their interest in intimacy again.

Endocrine system

Reproductive hormones make up part of the endocrine structure. During menopause, though, these vital hormones vanish from the scene, particularly causing hot flashes which can last for several years afterwards. 

Unexpected hot flashes can appear anytime, whether it’s during the day or night, and can last for mere seconds to several minutes. They come with a feeling of warmth along with flushed skin and perspiration.

Alterations to daily habits are essential for hot flush avoidance and management. Cutting out stimulants like coffee and tea can be of great help in this regard.

Incorporating routines focused on awareness, such as meditation and hypnotherapy, may provide aid in alleviating hot flashes.

During and after menopause, women begin to find it more difficult to lose weight and unhealthy weight tends to accumulate near the midsection. This is due to an energy-conservation system activated by menopause which makes it increasingly hard to burn calories and fat.

Immune and Excretory Systems

The decline in estrogen levels may lead to a serious medical issue called incontinence, for which one can start experiencing involuntary urine leakage when doing simple activities like laughing, exercising, or sneezing. Furthermore, the constant urges or even need to visit the restroom more often can seriously impair sleep quality.

Cardiovascular System

Estrogens bring about a cardioprotective effect for the body, meaning that if estrogen levels decrease, the risk of cardiovascular diseases increases.

This drop may have an effect on the body’s cholesterol levels, potentially increasing the risk of heart attack or stroke. To prevent and reduce these issues, your healthcare provider could recommend hormone replacement therapy.

Skeletal and Muscular Systems

As women go through menopause, their bones become weaker and they become more likely to sustain fractures due to reducing bone density. Moreover, menopausal women are even more prone to developing osteoporosis.

As women experience menopause, it is common to experience a decline in muscle mass and joint discomfort. Exercise can help prevent loss of bone density, maintain muscle mass, and reduce joint pain symptoms.

Effects of Menopause on the Mental State of Health

During the menopausal transition, several mental alterations can be observed as well. As such, scientists have observed dramatic changes in the female brain that take place over a four-year span surrounding a woman’s final menstrual period.

These studies mimic real-life hormone fluctuations experienced during this natural process, giving us greater insight into the effects of dwindling estrogen levels.

Nervous system

Menopause can impact a person’s outlook on life, causing a rollercoaster of emotions. One day they may feel well-balanced and happy, while the next they might find themselves struggling with varying states of unhappiness.

It’s a well-known fact that menopause can bring tumultuous emotional ups and downs. These moods often include periods of irritability. If the anxiety or depression continues for more than a few weeks, it’s important to talk to a doctor, as menopause can serve as a catalyst in the onset of depression.

During menopause, quality sleep can be compromised due to fluctuating estrogen levels. Hot flashes and night sweats can keep you up at night, making it hard to get the rest you need. These symptoms can have a significant effect on nighttime slumber.

Memory Declines

As menopause sets in, women regularly face cognitive deteriorations, which come through in the form of trouble remembering, slower verbal memory processing rate, and the difficulty to acquire new knowledge through verbal medium. Recent studies suggest that factors like age, hot flashes, depressive moods, stress levels and perceived health can largely predict the intensity of memory-related issues.

Women of a certain age typically display slight yet normal fluctuations in mental memory, knowledge comprehension, and speed of thought processing. However, it is helpful to remember that once past menopause often these cognitive abilities will restore to their usual state.

Change in Brain Structure

Women who are undergoing their menopause transition often display distinct modifications in the structure of their brain compared to their male counterparts of the same age group. These neurological differences can manifest into various red flags such as mood swings, depression, uneasiness and even Alzheimer’s disease for some women.

Researchers conducted a study with females who had monitors strapped to them and reported results which showed that those with more regular hot flashes were likelier to exhibit changes to the brain associated with ischemia than those with fewer. These findings hint that these minor strokes could have a substantial effect on intellect.

This raises the question: might alleviating hot flashes negate or minimize the white matter changes? While experts have faith this is probable, more research is required to give the definitive answer.

Post-Menopausal Recovery

As menopausal hormone levels decrease, the brain facilitates a compensatory adjustment. Consequently, menopausal signs like hot flushes often become less severe within two to seven years of initial onset. This adaptation may explain why such disturbances diminish over time.

Neuroimaging research indicates impressive outcomes in postmenopausal women. Gray matter volume sees rejuvenation back to similar levels to male counterparts of the same age. This breakthrough stands to reason, especially when considering gray matter concentration in certain portions of the brain linked with memory and higher cognitive processes. Moreover, these areas appear to expand over the course of several years following the transitional period.

During menopause, an accelerated rate of brain volume is associated with higher memory scores in the precuneus. This area is affected by hormone balance, similarly to how it changes during pregnancy – another biologically specific female stage marked by both neurological and hormonal shifts.

The volume of white matter in the brain of such women starts to decline and does not bounce back. Yet, even after menopause, female brains show increased structural connectivity and enhanced myelination within certain parts. This phenomenon could be linked to a better functioning neural network that develops in post-menopausal women.

Phases of Menopause – Changes In Each Phase of Menopause

Women’s reproductive health can be broken down into four distinct phases. Starting with the commencement of menstruation, this stage proceeds to encompass the years during which childbearing is possible. This is followed by menopause, when hormonal fluctuations decrease significantly compared to the previous stages, and finally culminating in further changes after menopause. Each of these phases of life sees distinct changes in a woman’s reproductive health, making them vital points of understanding.

Navigating the various phases of menopause can be a daunting journey if you’re not prepared. To help you understand the process, we will walk you through these phases to give you an idea of what to expect during each transition. This way, you can be better equipped to cope and handle this natural change.

What is Menopause?

As you reach menopause, your body will undergo drastic hormonal changes. Estrogen production is specifically affected as it declines, which may bring about a variety of different symptoms. This will be accompanied by a decline in how often you have periods until they eventually stop altogether.

The onset of menopause is not something that happens overnight. Oftentimes, the experience can last anywhere from several years to more than ten years. Navigating this transformative phase of life can be complex, yet it is possible with knowledge and understanding.

Your experience of menopausal signs will be like no other, and may fluctuate greatly in severity over the entire period. Generally, you’ll have times when these symptoms are more manageable, and times when they’re quite difficult to deal with.

What are the Stages of Menopause?

Menopause progression isn’t a sudden event; it involves shifts in hormone levels, most notably a decline in estrogen and a reduction in the number of viable eggs held in the female reproductive system.

There are four distinct stages of menopause:

  • Premenopause: As you progress into young adulthood, premenopause is the stage before any menopausal changes take effect. This time frame usually brings about regular menstrual cycles and dependable birth control to avoid pregnancy. The majority of ladies traverse this passage during their youthful adult years.
  • Perimenopause: This is a period of transition that all women experience as they approach menopause. It can last anywhere from one to ten years, sometimes even more. During this phase, you may start to notice changes in your body – everything from irregular menstrual cycles to hot flashes.
  • Menopause: After an entire year without experiencing a menstrual cycle, women may be entering menopause. This phase is marked by the cessation of female hormone production in the ovaries and the cessation of eggs being released. It is important to note that any medical conditions and medications can influence this milestone.
  • Postmenopause: The symptoms which you may experience during this period are likely to lessen and eventually subside. In spite of that, you become more susceptible to serious health issues like osteoporosis and heart disease.

Now, let’s break down each step of this journey. Let’s take a closer look at what the potential shifts are and how we can find relief.

Perimenopause Stages

The onset of menopause is marked by a period of change known as perimenopause, often compared to the anticipation and feeling right before something big.

As women approach menopause, they may start to experience perimenopause, the perimenopausal period. This transitional stage usually occurs four years prior to menopause. In some cases, it may begin up to decades before the actual menopause phase sets in.

Noticeable Changes

As you age, menopause can begin. This typically manifests itself through the irregularity of your menstrual cycle and periods. Note that this is actually the first sign of perimenopause.

As hormone levels shift due to the natural aging process, it’s common for your menstrual cycle to start changing. You may experience more frequent or imbalanced cycles, or even occasional missed periods. Along with this, it’s not uncommon for menopausal symptoms to occur during this phase of life.

Perimenopause can often bring about a selection of signs and symptoms, some of which may be more prominent than others:

  • Irregular or skipped periods
  • Altered amount of bleeding during periods
  • Hot flashes
  • Vaginal dryness
  • Increased frequency of urination
  • Sleep disturbances
  • Mood changes

The process of perimenopause isn’t always known for being succinct and delineated into two clear-cut stages. Although we use terms like “early menopause transition” and “late menopause transition” to try and define it, these phases are often quite blurry.

Early Transition

As you enter into the opening stages of perimenopause, your body switches into a new hormonal gear. Commonly, your menstrual cycles and periods will stay similar to their original look, however you might find yourself commencing to recognize extra signs and symptoms as well:

  • Hot flashes: Experiencing a few days of hot flashes is quite common, especially around the time of your menstrual cycle when your estrogen amounts go down.
  • Weight gain: As time goes on, a person may begin to see changes in their physique, particularly during the early stages of menopause.

If your symptoms are of a mild intensity, making simple changes to your everyday lifestyle could be a great option to manage them. Steps like establishing good sleep habits and introducing more cardiovascular exercises into your regimen could potentially increase your well-being.

However, if your issues become disruptive, it’s important to contact a medical expert, even if you’re still on a regular menstrual cycle. That’s why it’s always important to follow the rules.

Late Transition

As the menopause transition progresses, you are gradually heading toward menopause. During this time, you may observe the following characteristics:

  • Irregular periods: The regularity of a woman’s menstrual cycle is not always the same. Its duration may vary, as well as the intensity of her bleeding.
  • Subsequent period changes: The menstrual cycle can be disrupted by heavy bleeding during the following period. Estrogen alters the uterine lining causing thickness and ultimately leading to greater flows than usual.
  • Decreased libido: It may be shown through fewer desires for sexual activities or a lack of interest in engaging in them.

If you are having difficulty with missed menstrual cycles for a prolonged period of time and you are in your early 40s or younger, it is advisable to seek medical advice. This could be a sign of menopause starting earlier than expected or primary ovarian insufficiency.

Menopause

Menopause is typically diagnosed in women aged 50 or over, but can happen at any age. It has no predetermined boundary:

  • Early menopause: before the age of 45
  • Premature menopause: before the age of 40

The importance of the last period isn’t always crystal clear while on one’s menopause journey. It is indeed only when looking back after a year that you realize this was your last menstrual cycle.

Identifying the precise phase of menopause can prove difficult for some individuals. No matter if irregularities in one’s menstrual cycle are associated with medical conditions such as polycystic ovary syndrome, or induced through certain types of medication, including contraceptives, this determination remains tricky.

If you are not sure whether you’re in menopause, talk to a doctor for advice and see if testing is the right step. They can help walk you through the process.

Postmenopause

Postmenopause is a period of life where menopause symptoms such as hot flashes may become less frequent. In some cases, these signs may even stop altogether.

At this point, women can be at a heightened risk for a range of medical issues caused by the decline in estrogen. These conditions may include:

  • Cardiovascular disease: Estrogen has a protective role in the prevention of cardiovascular conditions like heart attack, heart disease, and stroke. When estrogen levels drop, individuals may be at an elevated risk of developing these diseases.
  • Osteoporosis: Estrogen, particularly, contributes significantly to building and sustaining bone density. Post menopause, this hormone decreases rapidly, elevating the likelihood of developing osteoporosis.
  • Vaginal atrophy: Insufficient estrogen can cause the vaginal lining to become thin and fragile, making it more prone to infections of the urinary tract.
  • Mental health issues: A shift in hormone levels can contribute to an increase in stress and feelings of despondency. This may present as a deterioration in mental health.

As you age, it is important to keep your doctor or healthcare provider informed about the changes menopause brings to your health. Even if you are feeling perfectly fine, taking a proactive stance and bringing up any questions or concerns you have in relation to menopause can have great benefits.

Conversation about menopause can be beneficial to uncover any potential troubles and guarantee that proper attention is received. Bringing up the conversation openly encourages everybody to gain more knowledge and alleviate any uncertainties.

What about Surgical Menopause?

Surgical menopause, a form of induced menopause, is brought about when the ovaries are taken out through surgery. This operation is generally performed to take care of issues such as endometriosis, or as a measure to prevent the risk of ovarian cancer in those with a BRCA gene.

Women who undergo ovary removal typically face a quick drop in their estrogen hormone levels. This can cause stronger than usual menopause symptoms, making it wise to reach out to a physician for assistance. They may have the best advice on how to deal with them, such as through HRT or non-hormonal alternatives.

Women who have undergone surgical menopause may experience an abrupt alteration from their premenstrual or perimenopausal phases to their postmenopausal stage.

When to Speak to a Doctor?

If the physical and emotional symptoms of menopause have become disruptive to your life and overall well being, it is essential to seek help and guidance.

Your healthcare specialist can serve as your personal navigator through the various available options, which could include:

  • Holistic strategies: This could mean introducing more healthy habits into daily living such as regular exercise, prioritizing quality sleep, and managing emotions and stress. Remember that it is rarely beneficial to consider any menopausal relief supplements without a provider’s direct recommendation.
  • Hormone therapy: It offers a range of treatment options to help address uncomfortable symptoms by boosting hormone levels. It’s critical to have a conversation with your doctor to determine the best course of action for your individual needs.
  • Non-hormonal treatment options: There exist various non-hormonal methods of treatment, including Selective Serotonin Reuptake Inhibitors (SSRIs). These medications are made use to provide alleviation from menopausal symptoms like hot flashes and fluctuations in mood.

Please note that yearly checkups with your healthcare provider are essential if you are struggling to find relief. Referrals and further examination may be recommended to help you better understand and manage your unique symptoms. Keep in mind, there is no magical fix – working together to find a solution is key.

An in-depth look into the specifics of your indicators is permissible and warranted.

To Conclude

Every woman’s journey through menopause is special to them – it happens at its own pace for everyone. If you are experiencing the effects of menopause, rest assured that there is an expansive selection of treatments suitable for every stage, from pre to post-menopause. Get in contact with your physician and discover which treatments are ideal for your individual circumstances.

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