@jamuraa definitely try injections or implants (expensive pellets) if you haven't yet. ime the anecdotal about injections having higher general efficacy are pretty true

there can be a rollercoaster effect from your blood levels varying over the injection cycle (up to 2 weeks typically) but i didn't notice that myself

what i did notice was the painful, long-lingering bruises i got on my thighs. took like 6 months after ceasing injections to finally stop being sore