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The decision framework: if your all-in cost with insurance (including time spent on prior auth and appeals) exceeds your cost with compounded medication, and you're comfortable with compounded medication's regulatory status, the compounded route is rational

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The decision tree: manage at home vs call your provider vs seek emergency care If your period is heavier than usual but you're not soaking through protection hourly: Manage at home Iron supplementation (325 mg ferrous sulfate daily with vitamin C) Ibuprofen 400 to 600 mg every 6 hours during heavy days (reduces menstrual blood loss by 25% to 30%) Track bleeding (number of pads/tampons per day) for 2 cycles If still heavy after 2 cycles or worsening, call your provider If your period is late and you're sexually active: Take a home pregnancy test If negative and period doesn't start within 7 days, repeat test If second test negative, call your provider for evaluation Don't assume "it's just the Zepbound" without ruling out pregnancy If you're having breakthrough bleeding or spotting: Manage at home if light (panty liner sufficient) Track timing (relation to dose, relation to meals, relation to stress) If bleeding is persistent (more than 10 days) or heavy (more than spotting), call your provider If bleeding occurs after menopause, call your provider immediately If you're soaking through protection hourly or passing large clots: Seek same-day care (urgent care or ED) This is not a "wait and see" situation Bring a list of medications including Zepbound dose and start date If your period stopped entirely: Take a pregnancy test If negative, assess caloric intake (are you eating enough?) If intake is adequate and you're not underweight, call your provider Amenorrhea beyond 3 months needs evaluation even if you feel fine Does birth control interaction matter

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