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Women should contact their GP or specialist if they develop severe or persistent symptoms potentially related to oestrogen changes, including: Significant worsening of menopausal symptoms (hot flushes, night sweats, mood changes) Vaginal dryness or discomfort affecting quality of life Unexplained changes in libido or sexual function Symptoms suggestive of bone health concerns (unexplained fractures, significant height loss) Mood disturbances or depressive symptoms Seek urgent medical attention if you experience: Severe, persistent abdominal pain (especially radiating to the back) with or without vomiting, which could indicate pancreatitis Upper right abdominal pain, fever, or yellowing of the skin/eyes, which might suggest gallbladder disease Signs of dehydration (extreme thirst, dry mouth, reduced urination, dizziness) Suspected pregnancy while taking semaglutide Routine monitoring during semaglutide treatment should follow NICE guidance for diabetes management or weight management programmes

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