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You would start retatrutide at the lowest dose and gradually increase it (called titration), regardless of what dose of tirzepatide you were on

(This is associative evidence and may reflect confounding by indication, surveillance patterns, and glycaemic differences.) For post-marketing pharmacovigilance, FAERS-based analyses of semaglutide identify multiple safety signals (e.g., gastrointestinal obstruction-related terms, dehydration/volume depletion in some GLP-1RA analyses), but vulvovaginal dryness/infection/discharge/pain are not prominent as labelled risks in the major semaglutide FAERS disproportionality paper retrieved here