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Sena and Chandel, 2012)

Estradiol + norethindrone Estradiol + norethindrone tablets (generic Activella) are a prescription medication that combine two hormones your body naturally produces

Take the following steps: Immediate management during an episode: Move to a quiet, safe space if possible Practice controlled breathing: breathe in slowly through your nose for 4 counts, hold for 4, exhale through your mouth for 6 counts Use grounding techniques: focus on physical sensations (feet on floor, objects you can see, sounds you can hear) Remind yourself that panic attacks, whilst distressing, are not dangerous and will pass If symptoms include chest pain, severe breathlessness, or you're unsure whether it's a panic attack, seek immediate medical attention by calling 999 or NHS 111 for urgent but non-emergency advice If experiencing thoughts of self-harm or suicide, seek urgent help via your local crisis team, A&E, or call 999 Follow-up actions: Contact your GP or prescribing clinician within 1-2 days to discuss your symptoms

There is some interest in using IGF1-LR3 to reduce the side effects of glucocorticoids and thus allow for more effective therapy[]