semaglutide effects on heart cardiovascular outcomes align more closely with attained dose than achieved weight loss Semaglutide Demonstrates Impressive Heart Benefits

According to NHS guidance, you should contact your GP urgently if you experience very heavy bleeding (causing flooding, passing large clots, or soaking through protection every hour for several consecutive hours), bleeding that lasts longer than seven days, persistent or heavy bleeding between periods, bleeding after sex, severe pelvic pain, or symptoms of anaemia such as extreme fatigue or dizziness

By inhibiting DPP-4, sitagliptin increases the concentration of two known active hormones of the incretin family: glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)

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Initial glucose-lowering effects typically occur within days to weeks, but maximum benefits including HbA1c reduction and cardiovascular effects may take up to 3 months to fully manifest

Jung et al, 2011)