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If you have hot flashes and arent in perimenopause, another condition or factor could be responsible

and taking anti-nausea medication if recommended by your provider can all help you tolerate the standard dosing

Alcohol, anabolic steroids, and recreational drugs can affect hormone balance and raise the risk

[1] The FDA prescribing information does not specify a required washout period before conception, so women should consult with their healthcare provider about appropriate timing
