Can GLP-1 drugs like Ozempic help with PCOS?
GLP-1 drugs such as Ozempic, Wegovy, and Mounjaro are best known for treating diabetes and supporting weight loss, but growing evidence suggests these medications may also help some people with polycystic ovary syndrome (PCOS). While not FDA-approved for PCOS, GLP-1s are increasingly considered for women with PCOS who struggle with weight or insulin resistance.
What are GLP-1 Drugs and How Do They Work?
GLP-1 receptor agonists are a class of medications that mimic a natural hormone, glucagon-like peptide-1 (GLP-1). They help regulate blood sugar by:
- Stimulating the release of insulin when blood sugar rises.
- Slowing stomach emptying, which helps reduce appetite and calorie intake.
- Acting on the brain to increase feelings of fullness.
Well-known GLP-1 drugs include Ozempic (semaglutide), Wegovy (semaglutide, higher dose for weight loss), and Mounjaro (tirzepatide). These medications are mostly used for type 2 diabetes and obesity management.
Are GLP-1s Approved for PCOS?
Currently, GLP-1 drugs are NOT FDA-approved for the treatment of PCOS. However, they are sometimes used “off-label” in women with PCOS—particularly those with obesity or insulin resistance—based on promising evidence from clinical studies. There is still a need for more large-scale, high-quality research before these drugs become standard care for PCOS.
How GLP-1 Drugs May Help PCOS Symptoms
GLP-1 drugs might help treat PCOS symptoms in several ways:
- Weight loss: GLP-1 drugs are highly effective for weight loss, which can be particularly valuable for people with PCOS and obesity. Many women using GLP-1s report significant and sustained weight reduction.
- Insulin resistance: Many women with PCOS have insulin resistance, a key underlying metabolic problem. GLP-1s improve insulin sensitivity, helping to lower blood sugar levels and reduce the risk of type 2 diabetes.
- Menstrual regularity and ovulation: Some studies have observed improved menstrual cycles and ovulation in women with PCOS taking GLP-1s, likely related to weight loss and improved hormone balance. However, the evidence is still limited and more research is ongoing.
- Other possible benefits: GLP-1 drugs may also help lower cholesterol, reduce inflammation, and improve cardiovascular risk in women with PCOS, though these benefits need more confirmation in studies focused on PCOS.
Who Might Benefit Most?
Women with PCOS who have obesity, marked insulin resistance, or who have not responded to metformin or cannot tolerate it, may benefit most from GLP-1 medications. However, these drugs are not considered first-line therapy and are reserved for select cases after other options have been tried.
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Risks and Side Effects
The most common side effects of GLP-1 medications like Ozempic are gastrointestinal. Nausea, vomiting, diarrhea, and constipation are frequently reported during the start of treatment, and get better over time for most patients. More rare but serious side effects include pancreatitis and gallbladder disease. Data are still limited for their use in reproductive-aged women specifically for PCOS; careful medical supervision is needed.
Cost and Access
GLP-1 drugs are often expensive and not covered off-label. Check with your individual plan to see whether these medications are covered for PCOS, and what your insurance company requires.
Can GLP-1s Improve Fertility?
Early evidence suggests GLP-1s may enhance fertility in women with PCOS, mainly through weight loss and improved metabolism. They are not direct ovulation-inducing drugs like clomiphene, but may help restore periods and ovulation as metabolic health improves. More research is needed to define their role in fertility treatment, and they should not replace standard fertility therapies at this time. What’s more, there is a lack of information regarding taking these medications around the time of conception as there are no studies of the safety of GLP-1 drugs in pregnant women.
How Do They Compare With Metformin?
Metformin, an oral diabetes medication, has a longer history of use for PCOS compared to GLP medications. There is evidence that metformin can regulate menstrual cycles in women with PCOS and improve fertility, though it is not approved for these uses. Below is a table that outlines key differences between metformin and GLP-1 drugs like Ozempic.
| Feature | Metformin | GLP-1 Drugs (Ozempic, etc.) |
|---|---|---|
| First-line status | Yes | No |
| Weight loss | Modest | Substantial |
| Cost | Low | High |
| Side effects | GI (mild, common) | GI (more frequent), rare severe |
| Evidence/history | Long established | Newer, growing research |
Clinical trials are ongoing to compare metformin with semaglutide in PCOS.
Bottom Line: Should You Consider GLP-1s for PCOS?
GLP-1 drugs are not a first-line treatment for PCOS, but may be helpful for some women, especially those struggling with obesity or insulin resistance. These medications should be considered only under the guidance of a healthcare provider, with careful evaluation of benefits, risks, and cost. Individual needs and circumstances should always drive treatment decisions.
References
- American Society for Reproductive Medicine. 2023. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Accessed on August 5, 2025 at https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/
- Goldberg, A. S., & Boots, C. E. (2024). Treating obesity and fertility in the era of glucagon-like peptide 1 receptor agonists. Fertility and sterility, 122(2), 211–218. https://doi.org/10.1016/j.fertnstert.2024.05.154
- McGovern, G. 2025. GLP-1 Receptor Agonists May Alleviate Symptoms in Patients With PCOS. In: Pharmacy Times. Accessed on August 5, 2025 at https://www.pharmacytimes.com/view/glp-1-receptor-agonists-may-alleviate-symptoms-in-patients-with-pcos
- University of Hull. (2024, May 10). Semaglutide vs Metformin in Polycystic Ovary Syndrome (PCOS). ClinicalTrials.gov. https://www.clinicaltrials.gov/study/NCT05646199?term=SEMAGLUTIDE&viewType=Table&page=13&rank=127
- Zhou, L., Qu, H., Yang, L., & Shou, L. (2023). Effects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review. BMC endocrine disorders, 23(1), 245. https://doi.org/10.1186/s12902-023-01500-5
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