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doi: 10.1016/j.virusres.2023.199261

Oral-contraceptive interaction and immunogenicity backup or non-oral contraception for 4 weeks after initiation and each escalation

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That gap is exactly why the compound is sold for research only

doi:10.1016/j.explore.2021.09.006 Pakowska-Godzik E, Lachowicz K, Rosoowska-Huszcz D

Here's a concrete example: Sarah, on month three of tirzepatide, started experiencing severe fatigue despite losing 22 pounds