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These include: Nausea (affecting 20-40% of patients initially) Vomiting Diarrhoea Constipation Abdominal discomfort These symptoms can be debilitating during the first few weeks of treatment and may cause fatigue, reduced appetite, and general malaise

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The cause of bleeding could be something as simple as vaginal tearing due to dryness or as serious as endometrial cancer, Hulon said

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