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While the primary symptom is intense abdominal pain, it can sometimes be accompanied by digestive changes that affect the stool

Estrogen has been shown to upregulate endogenous MOTS-c expression in preclinical models, which may partly explain why metabolic deterioration accelerates in perimenopause when estrogen falls precipitously [2]

But these two recent literature reviews, along with another published this year from the Cleveland Clinic, do offer preliminary guidance on how to manage the conditions when they overlap