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(Read More: Hormonal Imbalance symptoms, causes, treatment, medicine) Lifestyle Factors Daily habits and environmental influences can significantly impact the menstrual cycle: Stress: High levels of physical or emotional stress can affect the hypothalamus, a part of the brain that regulates the hormones involved in menstruation

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The methodological quality of the included studies, as assessed through the Jadad and NewcastleOttawa scales, varied from moderate to high, while the GRADE assessment indicated moderate certainty of evidence for serum vitamin B12 increase and low certainty for homocysteine reduction

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The manufacturer can prove, with clinical data, that the medication remains safe and effective through that date