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GLP-1s and PCOS: Surprising Facts You’ve Never Heard Before

by | Apr 17, 2024 | Last updated Apr 24, 2024 | Blog, Content, GLP-1s

Think of the eternal question about the chicken and the egg. The relationship between GLP-1s and PCOS isn’t all that different. So let’s start with what we know. First, GLP-1s can help you lose weight faster than if you were to try to lose weight on your own. Second, losing weight tends to improve PCOS […]

GLP-1s and PCOS

Think of the eternal question about the chicken and the egg. The relationship between GLP-1s and PCOS isn’t all that different. So let’s start with what we know. First, GLP-1s can help you lose weight faster than if you were to try to lose weight on your own. Second, losing weight tends to improve PCOS symptoms. Read on to learn more about what we know – and what we don’t – about GLP-1s and PCOS. 

So … which comes first? (Sorry, we couldn’t resist.)

If you have polycystic ovary syndrome (PCOS), a hormonal disorder that can cause a variety of symptoms and make it very difficult to get pregnant, chances are you’ve struggled with your weight. In fact, studies show that the majority of women with PCOS (38%-88%) carry more weight than is considered healthy. Researchers aren’t sure whether PCOS increases your risk for obesity, or obesity increases your risk for PCOS–but, either way, there’s a strong link between the two. 

If you do have PCOS and a high BMI, your doctor may have suggested that you try weight loss medication (such as GLP-1s). A recent study showed that semaglutide (the active ingredient in Ozempic and Wegovy) significantly reduced body weight in nearly 80% of patients with both PCOS and obesity who were unresponsive to previous weight loss measures. 

Do GLP-1s make you more fertile if you have PCOS?

GLP-1s speed up weight loss. Losing weight will help you have more regular periods, increase your fertility, and diminish the PCOS symptoms that make it difficult to get pregnant in the first place, including:

  • Irregular ovulation, making it harder to predict your most fertile days each month
  • Elevated insulin levels, causing erratic and irregular hormonal cycles, as well as increased hunger and tendency for your body to store more fat
  • Increased risk of ovarian cysts, which may negatively affect the ovaries’ ability to function well
  • Disruption to the formation of endometrium (uterus lining), leading to problems with a fertilized egg implanting

So, by losing weight you’re likely to give your fertility a boost.

You’ll also have a better chance of success if you need to use a form of assisted reproduction, such as in-vitro fertilization (IVF), because obesity has been shown to reduce the effectiveness of fertility treatments. 

Do GLP-1s decrease the chance of high-risk pregnancies for people with PCOS?

PCOS is linked to many complications during pregnancy, including preeclampsia (high blood pressure that can damage organs), gestational diabetes, heart problems, sleep apnea, premature birth, miscarriage, and C-Section. 

While you can’t take weight loss medication while you’re pregnant, you can use GLP-1s to reach your optimal weight before you get  pregnant – and yes, that can help minimize the risks associated with PCOS and pregnancy.

Can I take GLP-1s while I’m trying to conceive

You’ll need to stop taking GLP-1s three to six months before you try to conceive for safety. (Sorry).

Yes, we know obesity creates unique pregnancy risks. What we don’t yet know is how weight loss meds affect a developing fetus–or a breastfeeding baby. 

Do GLP-1s interfere with birth control?

It appears that the absorption and effectiveness of some types of birth control pills may be reduced by a GLP-1. Studies need to be done to help us better understand why, but in the meantime … better safe than sorry! 

Based on what we know right now, if you are currently taking birth control pills, use a back-up barrier method of birth control (such as condoms or a cervical cap) until you’re ready to try to get pregnant. Better yet, talk to your doctor about a more effective, non-oral contraceptive method (such as an implant or IUD) to see if you may be a candidate.

Related: GLP-1s and Birth Control–Everything You Need to Know

How do GLP-1s affect your period if you have PCOS?

Even if you’re not trying to get pregnant, losing weight (which tends to improve your PCOS symptoms) can deliver big benefits. Research shows that PCOS makes “normal” menstrual symptoms such as bloating and water retention even worse. By losing weight, you can expect to have more regular periods with less severe symptoms. (Yippee!)

Do GLP-1s have an anti-inflammatory effect on PCOS?

PCOS has been associated with chronic inflammation, and GLP-1s have been shown to have anti-inflammatory effects throughout the body, including the lungs, brain, liver, and kidneys. 

Weight loss meds have also been shown to improve both lipedema, abnormal fat build up in the legs, and lymphedema, swelling due to the build up of lymph fluid in the body–conditions that some people with PCOS and / or a high BMI suffer from. 

The takeaway on GLP-1s and PCOS

Research shows that people with PCOS who take weight loss meds (GLP-1s) before they conceive have more regular periods, as well as increased fertility rates. A happy side effect (at least for some people) of being more fertile is increasing your odds of getting pregnant! 

Becoming pregnant at a healthier weight also puts you at less risk for a variety of complications, including preeclampsia (high blood pressure that can damage organs), gestational diabetes, heart problems, sleep apnea, premature birth, miscarriage, and C-Section.

Some GLP-1s appear to reduce the effectiveness of oral contraceptives, but more studies are needed to better understand this. And, make sure to stop taking GLP-1s three to six months before you try to conceive. You’ll want them out of your system by the time you get pregnant, because we don’t know yet how these medications affect a developing fetus–or breastfeeding baby.

Note: GLP-1s are not FDA approved to treat obesity or for weight loss.

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Linda Anegawa, MD is Noom’s Chief Medical Officer where she brings decades of experience in academic primary care, bariatrics, advisory board service, and leadership in digital health. She is certified by the American Board of Obesity Medicine and the National Board of Physicians and Surgeons, and is a Fellow of the American College of Physicians.