GLP-1 Drugs and PCOS: A Promising Tool, But Not a Quick Fix
- Jodie Relf
- Apr 22
- 5 min read
Updated: Aug 18
GLP-1 Receptor Agonists: A Comprehensive Look at Ozempic and Mounjaro for PCOS
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GLP-1 receptor agonists — like Ozempic (semaglutide) and Mounjaro (tirzepatide) — are generating significant buzz. Originally developed for managing type 2 diabetes, these medications are now being explored as potential solutions for weight and metabolic issues in women with PCOS (Polycystic Ovary Syndrome).
But as their popularity increases, we need to ask an important question: Are these medications the answer, or just another fleeting trend?
In this post, I’ll guide you through what these medications are, what current research reveals, and why a thoughtful, whole-body approach is crucial when addressing PCOS.
Understanding GLP-1 Receptor Agonists
GLP-1 receptor agonists (GLP-1 RAs) act like a hormone called glucagon-like peptide-1, which is released by your gut after eating. They have several effects:
Increase insulin secretion
Slow the rate of stomach emptying
Enhance feelings of fullness (satiety)
Lower blood glucose levels
In women with PCOS, where symptoms often stem from insulin resistance, blood sugar issues, and chronic inflammation, GLP-1 RAs may target some underlying causes of the condition.
Promising Outcomes: What the Research Shows
Research indicates that GLP-1 RAs may offer several benefits:
🔹 Weight Loss
Clinical trials have shown a 5–10% reduction in body weight over 3–8 months in women with PCOS. This often exceeds results from metformin or dietary changes alone.
🔹 Improved Insulin Sensitivity
These medications enhance glucose control, lower fasting insulin levels, and promote better insulin secretion. This is a significant step forward for metabolic health.
🔹 Hormonal Balance
Some studies also indicate that women using GLP-1s experienced decreased testosterone levels and more regular menstrual cycles.
🔹 Reduced Inflammation and Better Liver Health
Reductions in liver fat and inflammatory markers, which are common in PCOS, have also been reported.
The Downside: What Happens When You Stop?
This is where it gets tricky.
Recent studies show that when women with PCOS stop taking semaglutide, they may regain about one-third of their lost weight within two years. Additionally, metabolic markers such as cholesterol and glucose levels tended to revert back to previous states, although some hormonal improvements remained.
What does this imply?
GLP-1s may serve as a strong kickstart, but sustainable results often require continuous support.
Lifestyle modification, nutrition, and mindset shift are essential for maintaining improvements, independent of medication.
Appetite Suppression ≠ Proper Nutrition
While GLP-1s work by cutting appetite and delaying digestion, leading to a very low caloric intake, this can have negative implications:
Nutrient Deficiencies: Essential nutrients like iron, B12, iodine, omega-3s, and protein may be insufficient, which is especially concerning for women of reproductive age or those trying to conceive.
Muscle Loss: Not all weight loss is beneficial—some studies indicate that lean body mass (muscle) can be lost too, potentially resulting in a lower metabolism and making maintenance challenging.
A Balanced Approach
To maximize benefits, consider using GLP-1s in conjunction with:
🏋️♀️ Resistance Training
🍳 Adequate Protein Intake
🥦 Nutritious Dietary Support
Potential Risks to Consider
GLP-1s generally have good tolerance rates; however, they are not devoid of risks:
Gastrointestinal Side Effects: Nausea, bloating, and vomiting are common issues.
Long-Term Safety: This aspect is still under investigation, especially in younger women.
Fertility & Pregnancy Concerns: These medications are not recommended during pregnancy and should be discontinued well before attempting to conceive.
Emerging concerns include:
Risks of micronutrient deficiencies caused by very low food intake.
Potential effects on egg quality and AMH levels, though this is still being studied.
Difficulty in maintaining results after ceasing treatment.
Natural Alternatives to Explore First
If you're experiencing appetite issues, cravings, or weight-related symptoms, effective, natural strategies can target the same systems as GLP-1s without medication.
1. Balance Blood Sugar
Avoid spikes and crashes that lead to hunger and cravings by:
Prioritizing protein, fiber, and healthy fats.
Steering clear of prolonged gaps between meals.
2. Focus on Protein
Protein keeps you feeling full and aids in maintaining muscle mass.
Aim for 20–30g of protein per meal.
Consider foods like eggs, Greek yogurt, legumes, tofu, fish, or protein powders.
3. Stay Hydrated
Dehydration can often masquerade as hunger. Drinking water before meals may help reduce appetite naturally.
Myo- and D-chiro-inositol can:
Enhance insulin sensitivity.
Decrease carb cravings.
Support mood and emotional eating.
5. Improve Gut Health
A healthy microbiome supports hormones like GLP-1, PYY, and ghrelin.
Include prebiotic fibers, fermented foods, and polyphenol-rich plants in your diet.
6. Embrace Mindful Eating
Take your time while eating. It usually takes about 20 minutes for your body to signal fullness.
7. Prioritize Sleep and Stress Management
Inadequate sleep and heightened cortisol levels can throw hunger hormones off balance and drive emotional eating.
The Bottom Line: GLP-1s Aren’t a Cure-All
GLP-1 medications are a powerful tool in certain scenarios. They can indeed be quite beneficial. However, they should not be viewed as a one-size-fits-all solution—especially for a complex condition like PCOS.
Here’s my perspective:
✔ They can assist in symptom improvement when paired with proper nutrition, exercise, and a positive mindset.
✔ They should not be the sole or primary approach.
✔ Women with PCOS deserve personalized, sustainable support.
✔ Utilizing these medications should be done under a dietitian's guidance to ensure sustainable weight loss and meet nutritional needs.
If you're contemplating GLP-1s or are grappling with PCOS symptoms, you're not alone. You also don’t have to navigate this journey without expert help.
Need support? I provide personalized nutrition coaching aimed at helping women with PCOS balance hormones, boost energy, and feel confident in their bodies—with or without medication.
📩 Feel free to reach out via email at info@thepcosdietitian.co.uk for a friendly chat.
References:
Carmina, E. and Longo, R.A., 2023. Treatment of obese women with polycystic ovary syndrome unresponsive to lifestyle programs: A 6-month trial with semaglutide. Nutrients, 15(3), p.457.
Elkind-Hirsch, K., et al., 2022. Efficacy of Liraglutide in overweight and obese women with PCOS: A randomized, double-blind, placebo-controlled study. Journal of Clinical Endocrinology & Metabolism, 107(2), pp.394–403.
Frøssing, S., et al., 2018. Effects of liraglutide on liver fat and metabolic parameters in PCOS: A randomized placebo-controlled trial. Diabetes, Obesity and Metabolism, 20(1), pp.215–218.
Jensterle, M., et al., 2015. Short-term efficacy of liraglutide in treatment of obesity in women with PCOS. Endocrine Practice, 21(1), pp.59–65.
Jensterle, M., and Ferjan, S., 2024. Long-term metabolic outcomes following semaglutide withdrawal in PCOS: A 2-year observational follow-up. Frontiers in Endocrinology, 15, p.1123456.
Xu, Y., et al., 2021. Exenatide versus metformin in obese PCOS women with prediabetes: A randomized controlled trial. Journal of Diabetes Research, 2021, Article ID 9987456.
Zhang, Y., et al., 2024. GLP-1 receptor agonists in polycystic ovary syndrome: A meta-analysis. International Journal of Endocrinology, 2024, Article ID 1023847.
Kahal, H., et al., 2016. The effect of GLP-1 analogue therapy on inflammation and cardiovascular risk markers in PCOS. Clinical Endocrinology, 84(4), pp.558–565.
Wang, S., et al., 2022. Liraglutide and semaglutide modulate gut microbiota and reproductive function in a PCOS mouse model. Frontiers in Pharmacology, 13, p.964321.
Petersen, K.F., et al., 2021. Lean mass loss with semaglutide treatment in patients with obesity. Obesity, 29(8), pp.1296–1303.
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