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The B12 in your compounded formulation should keep serum B12 levels adequate in most cases, but "most cases" is not "all cases." Verify with bloodwork rather than assuming

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Refrain from injecting while the thigh is cold or after extended sun exposure, as these conditions alter blood flow and medication absorption dynamics

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Key considerations include: Rybelsus is not a hormonal contraceptive and does not directly alter oestrogen or progesterone levels Any menstrual changes are likely secondary to metabolic improvements rather than a direct drug effect Individual responses vary considerably, and not all women will experience cycle alterations Other common causes of menstrual changes (pregnancy, perimenopause, gynaecological conditions) should be considered first If you notice changes to your menstrual cycle after starting Rybelsus, it is important to discuss these with your GP or diabetes specialist nurse