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Mechanism: Increased protein synthesis, myofibril expansion, and sarcoplasmic growth
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otherwise observation Breakthrough bleeding or spotting between periods: Likely mechanism: fluctuating estrogen levels during active weight loss Typical timeline: episodic during weeks 4 to 20 Associated findings: correlates with weeks of accelerated weight loss What it means: uterine lining is responding to unstable estrogen levels Management: usually benign
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