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Polycystic Ovary Syndrome (PCOS) and GLP-1 Medicines: What You Need to Know

Introduction

Polycystic Ovary Syndrome (PCOS) affects up to one in ten women of reproductive age and can cause irregular periods, acne, excess hair growth, and weight gain. Many women also have insulin resistance, which increases the risk of type 2 diabetes and makes weight loss harder (3,7).

Medicines such as Wegovy (semaglutide) and Mounjaro (tirzepatide) are GLP-1–based treatments that support weight loss and metabolic health. Research suggests they can improve weight, insulin resistance, and menstrual regularity when combined with lifestyle changes (1–3,5,6,8–10).

 

How GLP-1 Medicines Work in PCOS

GLP-1 is a gut hormone that regulates appetite, digestion, and blood sugar. GLP-1 medicines:

  • Reduce appetite and increase fullness (1,2).
  • Slow gastric emptying, helping control hunger (1,2).
  • Improve insulin sensitivity and lower fasting insulin/glucose (3,5).

They support weight loss, which can restore hormonal balance and more regular periods (3–6). Tirzepatide acts on GLP-1 and GIP receptors and may provide greater metabolic improvements than medications which solely act on GLP-1 (semaglutide) acting medications alone (1,2,8).


Evidence for GLP-1 Medicines in PCOS

Studies show that GLP-1 medicines can help women with PCOS lose weight, balance hormones, and improve symptoms linked to insulin resistance. On average, women lose about 5 -15% of their body weight, with improvements in waist size, blood sugar, and insulin levels (3,5,10). As weight and insulin sensitivity improve, many notice more regular periods and signs that ovulation has returned (4,7,10). GLP-1 treatments can also help lower testosterone levels, which may reduce acne and unwanted hair growth (5,6). Compared with older treatments such as metformin, GLP-1 and dual GLP-1/GIP medicines have shown stronger overall benefits for metabolism and hormone balance (8,9). Although these medicines may improve fertility by restoring normal cycles, they are not fertility drugs and must be stopped before pregnancy (7,12).

 

What Patients Should Consider:

1. Before starting

  • Discuss goals (weight, menstrual regularity, fertility) with your GP/specialist.
  • Use reliable contraception; GLP-1s must be stopped before conception (12).
  • GLP-1s may be used alongside metformin and/or hormonal therapy (7).

 

2. During treatment / Maintenance

  • Track periods and symptom changes (acne, hair growth, mood) (4–6).
  • Report persistent nausea, vomiting, or abdominal pain (12).
  • Combine treatment with nutrition and physical activity for best outcomes (3,7,9).

  • If planning a pregnancy, stop GLP-1s before conceiving. Semaglutide should be stopped at least 2 months before and tirzepatide at least 1 month prior to trying to conceive (12).

     

3. Lifestyle Tips for PCOS & Weight Management

  • Consuming a balanced diet with higher protein/fibre; fewer refined carbs can help with PCOS (7,9).
  • Regular exercise can help improve insulin sensitivity. Ensure to combine aerobic and resistance training.  (7,9).
  • Sleep & stress: both influence insulin and hormones (7).


4.When to Seek Medical Advice 

  • If you suspect pregnancy while using GLP-1 treatment.
  • If you experience any unusual vaginal bleeding or discharge that is persistent or heavy. 
  • If you experience severe or ongoing nausea, vomiting, or abdominal pain, because this could signal a reaction such as pancreatitis or gallbladder irritation.

For severe symptoms — such as severe abdominal pain, shortness of breath, or fainting — call 999 or attend A&E. 

 

Summary

GLP-1 medicines like Wegovy and Mounjaro can help women with PCOS lose weight, improve insulin resistance, regulate cycles, and reduce androgen-related symptoms (1–6,8–10). They should be medically supervised and stopped before pregnancy (12). With lifestyle changes and regular review, many women achieve meaningful improvements in health and wellbeing (3,7,9).

 

References 

  1. Frias JP, Nauck MA, Van J, et al. Efficacy and safety of tirzepatide versus semaglutide once weekly in type 2 diabetes (SURPASS-2). N Engl J Med. 2021;385(6):503–15.
  2. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205–16.
  3. Wang L, Xu Y, Li Q, et al. Efficacy and safety of GLP-1 receptor agonists in women with PCOS and obesity: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2024;15:1330936.
  4. Nylander M, Frøssing S, Kistorp C, et al. Effect of liraglutide on reproductive hormones and ovarian function in obese women with PCOS. J Clin Endocrinol Metab. 2017;102(12):4362–71.
  5. Elkind-Hirsch K, Marrioneaux O, Bhushan M, Vernor D, Bhushan R. Comparison of GLP-1 receptor agonist therapy with metformin in obese women with PCOS: a randomized trial. Fertil Steril. 2018;109(3):638–47.
  6. Elkind-Hirsch K, Marrioneaux O, Bhushan R. Impact of liraglutide on hyperandrogenism and metabolic parameters in PCOS. Endocr Pract. 2019;25(7):683–92.
  7. Jensterle M, Janez A, Fliers E, et al. GLP-1 receptor agonists in the treatment of PCOS: a review. Hum Reprod Update. 2020;26(3):377–93.
  8. Zhao H, Tang X, et al. Superior metabolic improvement of PCOS traits with GLP-1/GIP multi-agonists vs metformin. Nat Commun. 2024;15:52898.
  9. Lee S, Rahman F, et al. Comparative efficacy of pharmacological interventions on metabolic and hormonal outcomes in PCOS: a network meta-analysis. BMC Womens Health. 2025;25:35–46.
  10. Berton S, Di Francesco S, et al. Semaglutide treatment of excessive body weight in obese women with PCOS. Nutrients. 2024;16(7):1105.
  11. Al Jubouri MA, Al Hamdani FH, et al. The potential utility of tirzepatide for the management of PCOS. Cureus. 2023;15(7):e42155.
  12. Wegovy (semaglutide) Summary of Product Characteristics. Novo Nordisk Ltd; 2024.

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