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Figure 1 Characteristics of included studies To ensure methodological clarity and appropriately weight the evidence, the included literature is organized into four distinct categories: completed head-to-head trials, contextual cardiovascular outcome trials, real-world observational studies, and ongoing (non-analytical) studies

This plan includes adhering to a balanced, nutritious diet low in processed foods and sugars, and high in vegetables, fruits, and whole grains

Long-term considerations Remember that both medications work best when combined with healthy eating habits and regular physical activity

Contact your GP if you experience: Three consecutive missed periods , especially if your cycles were previously regular Unusually heavy bleeding soaking through a pad or tampon every hour for several hours in a row, or passing large clots Bleeding between periods or after sex Severe cramping or pain thats significantly different from your usual period discomfort Dramatic changes in cycle regularity or length from whats normal for you for example, going from a consistent 28 days to 45 days or 18 days Our clinicians at Click2Pharmacy can advise on whether your period changes are within the expected range or if you need further assessment