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Xue et al., 2004b

Understanding the underlying mechanism is key to being informed

However, assessment of long-term, hard clinical kidney endpoints has been limited by the three- to fivefold higher risk of hyperkalaemia with spironolactone use [66]

Elevated estrogen has predictable effects on the menstrual cycle: Proliferative phase lengthens (uterine lining thickens more than usual) Breakthrough bleeding occurs if estrogen drops suddenly after a surge Next period may be heavier because the lining is thicker Estrogen can delay ovulation, shortening the luteal phase The phenomenon is well-documented in bariatric surgery literature