How Ozempic Affects Birth Control, Fertility, and Hormones

Introduction

If you’re a woman considering or taking a GLP-1 medication—like Ozempic, Wegovy, Victoza, Saxenda, or Mounjaro—you’re not alone in having questions. Many women wonder how these medications might impact birth control, menstrual cycles, fertility, menopause, and overall hormonal health.

This guide brings together the latest research and real-world insights to help you make empowered, informed decisions.

What Are GLP-1 Medications and How Do They Work?

GLP-1 receptor agonists are a class of medications that mimic the hormone glucagon-like peptide-1. Originally developed for type 2 diabetes, they are now widely used for weight loss, especially in patients with obesity and metabolic dysfunction.

These drugs work by:

Stimulating insulin production
Suppressing appetite
Slowing gastric emptying

This helps regulate blood sugar and promote sustainable fat loss.

Key benefits for women

Improved blood glucose control
Sustainable weight loss
Reduced risk of heart disease and stroke
Hormonal balance support during menopause and perimenopause
Potential improvements in PCOS, fertility, and hormonal balance

GLP-1s and Birth Control: What Every Woman Should Know

Do GLP-1s Affect the Effectiveness of Birth Control Pills?

This is one of the most common, and important questions women ask.

Because GLP-1 medications slow down digestion, there’s concern they might delay or reduce the absorption of oral medications, including contraceptive pills.

What does the research say?

For semaglutide, liraglutide, and dulaglutide, studies show no significant effect on the absorption or blood levels of contraceptive hormones.
For tirzepatide (Mounjaro®), the story is different. It may reduce the effectiveness of oral contraceptives, especially within the first 4 weeks after a dose change.

What should you do?

If you’re on semaglutide, liraglutide, or dulaglutide: No extra birth control precautions are needed, but consistency is key—take your pill at the same time every day.
If you’re on tirzepatide: Use a backup method (like condoms) or consider a non-oral contraceptive for at least four weeks after starting or increasing your dose.
If you experience vomiting or diarrhea: Use additional protection, since these side effects can impact absorption.

GLP-1s and Menstrual Cycles: What to Expect

Many women report changes to their menstrual cycles after starting a GLP-1 medication. This is especially common among women with PCOS or significant weight loss.

What changes might occur?

More regular or predictable periods
Lighter or more frequent periods
Improved ovulation (especially in PCOS cases)

One meta-analysis of randomised controlled trials found that women with PCOS who used GLP-1 receptor agonists for 24 weeks or more saw significant improvements in menstrual frequency and regularity compared to those on metformin or placebo.

Why does this happen?

GLP-1s help restore normal hormone patterns by improving insulin sensitivity and supporting healthy weight loss, both of which are key factors in regular cycles.

If your cycle changes significantly or you’re worried, reach out to your provider. You deserve answers and support.

GLP-1s and Fertility: Surprising Benefits and Considerations

Can GLP-1s Improve Fertility?

Yes—especially in women with obesity or PCOS.

GLP-1s help by:

Improving insulin resistance
Reducing androgen (male hormone) levels
Restoring regular ovulation and menstrual cycles

One study showed GLP-1s outperformed metformin in improving fertility traits in PCOS models.

There are also many real-world reports of women becoming pregnant unexpectedly after starting GLP-1 therapy—even while using birth control.

Are GLP-1s Safe While Trying to Conceive?

GLP-1s are not recommended during pregnancy due to limited safety data. If you’re planning to get pregnant:

Talk with your provider about when to stop your medication
Use effective contraception until you’re ready to conceive
Plan a “washout” period as advised by your doctor

If you find out you’re pregnant while on a GLP-1, don’t panic—reach out to your provider for guidance and reassurance.

GLP-1s and Hormonal Health: Beyond Fertility

GLP-1s offer broader hormonal health benefits for women, including:

PCOS symptom relief (lower androgens, better cycles)
Menopause support: Weight control, metabolic health, fewer hot flashes
Period pain relief: Anecdotal reports suggest anti-inflammatory effects may reduce cramping

One study suggests GLP-1s stabilise the hypothalamus, potentially reducing hot flashes in menopausal women.

GLP-1s, Weight Loss, and Sex Differences

Women may respond differently than men to GLP-1 drugs.

CNN Health reports that women often experience greater weight loss with GLP-1s, possibly due to differences in estrogen and fat distribution. However, women may also be more likely to experience side effects like nausea or constipation.

A study by Dr. Karolina Skibicka found that estrogen increases GLP-1 receptor activity, amplifying weight loss and appetite control.

GLP-1s: Safety, Side Effects, and Special Considerations

Common Side Effects

Nausea, vomiting, diarrhea
Constipation, fatigue, headache

Rare Risks

Pancreatitis
Gallstones
Intestinal blockages

Special Considerations for Women

Bone health: Rapid weight loss can lower bone density. If you're postmenopausal or osteopenic, monitor closely.
Mental health: Some women report anxiety or mood swings. Seek support if symptoms persist.
Pregnancy/Breastfeeding: Avoid use during pregnancy and lactation unless otherwise advised.

Frequently Asked Questions (FAQs)

Can I take GLP-1s if I’m on birth control?
Yes, but tirzepatide (Mounjaro®) may reduce oral contraceptive effectiveness. Use a backup method for four weeks after starting or increasing the dose.

Will GLP-1s affect my period?
Yes, especially in women with PCOS. GLP-1s may improve ovulation and menstrual regularity.

Can GLP-1s help with PCOS?
Absolutely. They improve insulin sensitivity, reduce androgens, and help normalize cycles.

Should I stop GLP-1s if I want to get pregnant?
Yes. Work with your doctor to safely taper and stop the medication before trying to conceive.

Are GLP-1s safe during pregnancy?
Data is limited. For now, avoid GLP-1s while pregnant or nursing until more evidence is available.

Practical Tips for Women Using GLP-1s

Track your cycles and note any changes—your experience is valid.
Review your birth control method with your doctor, especially if you’re taking tirzepatide.
Plan ahead for pregnancy and discuss a washout period with your provider.
Monitor for side effects and don’t hesitate to reach out to your healthcare team.
Stay informed: GLP-1 research is rapidly evolving—check for updates from trusted medical sources.

You’re Not Alone—And You Deserve Answers

Starting or continuing a GLP-1 can feel overwhelming, especially with so much information (and misinformation) online. Remember, it’s normal to have questions and concerns. Your health journey is unique, and you deserve care that’s tailored to you.

If you ever feel uncertain, reach out to your provider.

Founder’s Note

As someone who works closely with GLP-1 users and the teams behind these medications, I see firsthand how science and real-life experience come together.

At GLP-1 Approved, our mission is to translate the latest research into practical tips, curated products, and real-world support for your journey.

We want to help you feel your best—every step of the way.