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Your provider may adjust this based on your IGF-1 response and tolerance

During the secretory phase, the total endometrial thickness remains relatively fixed, despite continued elevated estradiol levels (Moyer and Felix, 1998)

Hypomania is classified as the presence of 3 of the following symptoms: An inflated self-esteem, self-confident or grandiosity A decreased need for sleep An excessive involvement in risky, but pleasurable activities Increased distractibility and an inability to stay focused Overly talkative behavior Need to participate in goal-directed activities Racing thoughts or subjective experiences Fortunately, hypomanic episodes do not necessitate hospitalization

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In a minority of patients, MS begins with a progressive course from onset where inflammation may be less prominent, though still plays a role in disability progression (Hughes et al., 2018)