In regards to noticing physical changes, it could just be the initial burst of changes has subsidized and has become more gradual now. For example, to focus specifically on nipple pain you mentioned, I've taken E sublingually for the past 7 months, the dose has been upped twice during that time, last time around 3 weeks ago. The pain that use to be present under my areola is now less prevalent than it was a few months ago at half the dose.