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Rapid weight loss changes estrogen levels, and the hormonal shifts that accompany significant fat loss can temporarily alter cycle timing, flow, and symptoms

This allow the molecule to get into the body but bypasses the gut

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Molecular Role of Semaglutide in Skeletal Muscle Homeostasis The interaction between GLP-1 and GLP-1R is observed to present a strong impact on the AMPK signaling within skeletal muscle tissue, augmenting mitochondrial biogenesis, oxidative phosphorylation and metabolism of muscle tissue [180]

Diabetes 59 , 10301037 (2010)

What Mechanistic Evidence Can and Cannot Prove Rodent mechanistic findings support why the warning exists Human mechanistic data does not confirm a comparable risk pathway Therefore, the burden shifts to high-quality human data Bottom Line: If GLP-1 drugs caused MTC in humans like in rodents, we'd expect clearer biologic signals in human C-cells and biomarkers