Combined oral contraceptive pills are often used to manage menstrual irregularity and androgen-related symptoms, while metformin is commonly prescribed to address insulin resistance and other metabolic issues ( 13 )
If you notice reduced effectiveness at doses that previously worked well, degradation is a likely culprit
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Transl Psychiatry 11(1):26 Hunter K, Hlscher C (2012) Drugs developed to treat diabetes, liraglutide and lixisenatide, cross the blood brain barrier and enhance neurogenesis