Women and GLP-1 Medications: What You Need to Know

If you have PCOS, there is some anecdotal evidence that these medications might actually be particularly helpful for you, but there are some important things to be aware of. PCOS is closely linked with insulin resistance, and one of the things GLP-1 medications do is improve how your body responds to insulin. For many women with PCOS, this can be genuinely transformative. Better insulin sensitivity can help with weight loss, which is often really difficult with PCOS, and it can also help regulate your menstrual cycle.

I've seen women with PCOS who haven't had regular periods for years suddenly find that their cycles start to regulate when they're on these medications. This happens because improving insulin resistance helps balance the other hormones involved in your menstrual cycle. Some women also notice improvements in other PCOS symptoms, like excess hair growth or acne, as their hormones start to balance out.

Here's something absolutely crucial that you need to know: if you have PCOS and you've been struggling with irregular periods or haven't been ovulating regularly, these medications might restore your cycle and therefore alter your fertility. We're seeing what some people are calling 'Ozempic babies', women who thought they couldn't get pregnant suddenly finding themselves pregnant after starting these medications.

As your insulin resistance improves and your weight decreases, your hormones can rebalance, and you might start ovulating again, sometimes without even realising it. If you're not planning to get pregnant, you need to use reliable contraception. Don't assume that because you've had irregular periods or haven't been able to conceive before that you're safe now. And if you do want to get pregnant, you need to come off these medications first. We don't have enough research yet about their safety during pregnancy.

If you're in perimenopause or menopause and considering these medications, there are a few things you need to know. The good news is that GLP-1 medications work just as well for women going through menopause as they do for younger women. In fact, some recent research suggests they might work even better when combined with hormone replacement therapy.

When oestrogen levels drop during menopause, your body starts storing fat differently. Instead of distributing it around your hips and thighs, it heads straight for your belly. This visceral fat, the fat around your organs, is particularly stubborn and also carries health risks. Women taking both GLP-1 medications and HRT tend to lose more weight than those taking GLP-1s alone.

There's something that might catch you off guard: some women who are postmenopausal report experiencing bleeding when they start losing weight on these medications. Fat tissue stores oestrogen, so as you lose weight, that stored oestrogen can be released back into your bloodstream, potentially causing breakthrough bleeding even if your periods stopped years ago. If this happens, do speak to your doctor. Overall, these medications offer real hope for women at every stage of life who have struggled with their weight, providing an opportunity to improve not just weight but overall hormonal health.