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Who should select which tier If you are new to GLP-1 medications , or have not taken one in some time, you will begin at Tier 1

Pergola PE, Raskin P, Toto RD, Meyer CJ, Huff JW, Grossman EB, Krauth M, Ruiz S, Audhya P, Christ-Schmidt H, Wittes J, Warnock DG (2011) BEAM Study Investigators

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Early programmes, institutional studies, and preclinical model work examined how the compound class might influence receptor signalling, cellular adaptation, or tissue-level response patterns under controlled conditions

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Guideline Statement 12 Appropriate manual physical therapy techniques (e.g., maneuvers that resolve pelvic, abdominal and/or hip muscular trigger points, lengthen muscle contractures, and release painful scars and other connective tissue restrictions), if appropriately trained clinicians are available, should be offered to patients who present with pelvic floor tenderness