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First steps with menstrual changes : Take a pregnancy test if you've missed periods or have unexpected bleeding Discuss with your GP before starting any supplements, including iron or multivitamins If you're taking hormonal contraceptives and experiencing vomiting or diarrhoea from Victoza, be aware this may reduce contraceptive effectiveness follow NHS guidance on 'pill sickness' and consider using condoms temporarily Nutritional considerations : Ensure adequate caloric intake despite appetite suppressionvery low calorie intake can disrupt menstrual function Maintain sufficient iron intake through diet if periods become heavier (your GP may check a full blood count before recommending supplements) Stay well hydrated, particularly if experiencing gastrointestinal side effects Lifestyle factors : Engage in regular moderate exercise , which supports both diabetes management and hormonal balance Manage stress through relaxation techniques, as stress can independently affect menstrual regularity Ensure adequate sleep, as sleep deprivation can influence both glucose control and reproductive hormones Medical management : Your GP may recommend investigations such as pregnancy testing, blood tests (including full blood count, thyroid function, and reproductive hormones) or pelvic ultrasound to exclude other causes of menstrual changes