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The considerations are practical rather than a hard contraindication: side-effect overlap and absorption timing

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For many women using continuous combined HRT after menopause, periods eventually stop altogether

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More serious but less common risks include pancreatitis (seek urgent medical attention for severe, persistent abdominal pain, sometimes radiating to the back), gallbladder disease, and diabetic retinopathy complications (particularly in people with pre-existing retinopathy)

Some protocols alternate between daily and reduced frequency