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How GLP-1s might affect hormonal birth control
What the research says and what you might want to discuss with your healthcare provider
Disclaimer: This article has been sponsored by Bayer
Top things to know about GLP-1s and birth control:
Ozempic doesn’t affect how well the birth control pill works
Mounjaro may reduce how much of the pill gets absorbed
Side effects of GLP-1s, like vomiting, can also prevent the pill from being fully absorbed
Non-oral birth control methods (IUD, implant, patch, or shot) remain effective
Choosing reliable contraception is important when taking GLP-1s, as they are not recommended during pregnancy
What are GLP-1 medications and why are they used?
GLP-1 (glucagon-like peptide-1) is a natural hormone released from the gut after eating, helping to regulate blood sugar, curb appetite, and slow digestion (1). GLP-1 receptor agonists—like semaglutide, the active ingredient in Ozempic and Wegovy—are prescription medicines that mimic this hormone (1).
GLP-1s were originally developed to treat type 2 diabetes and are now increasingly used to treat obesity (1). Tirzepatide, the active ingredient in Mounjaro, works on both GLP-1 and another hormone called glucose-dependent insulinotropic polypeptide (GIP).
Most GLP-1 medicines are taken as weekly injections into the abdomen, thigh, or upper arm (1,2).
You may have seen GLP-1s marketed as “weight loss injections,” but GLP-1 medications are not lifestyle products. They’re powerful medicines that should only be used under the guidance of a healthcare professional (2).
GLP-1s and PCOS
PCOS (polycystic ovary syndrome) is a common condition where there is an imbalance of certain hormones, such as elevated androgen levels. It can cause unpredictable or absent ovulation and often unpredictable menstrual cycles. PCOS is often linked to metabolic issues like insulin resistance, high blood pressure, and an increased risk of diabetes, making timely diagnosis and tailored care important (3).
GLP-1 medications may be a new option for helping treat PCOS by reducing weight and insulin resistance, particularly in those with obesity or other metabolic concerns. They can be used instead of, or alongside, Metformin to manage PCOS symptoms, particularly when weight loss is a main goal.
People respond differently to GLP-1s, so treatment should be personalized. While early findings are promising, more research is needed to understand the long-term effects when GLP-1s are used with other treatments (4,5).
How might GLP-1s affect birth control pills?
The impact of GLP-1 medications on birth control pills depends on the specific type of GLP-1 you’re using.
Mounjaro
Mounjaro can temporarily reduce how much of the pill is absorbed in the stomach (6). Barrier methods, like condoms, are advised for 4 weeks after starting or increasing the dose, or a non-oral birth control could be used, such as the IUD, vaginal ring, or hormonal implant (6).
Ozempic and Wegovy
Other GLP-1 medications, such as Ozempic or Wegovy, have not been shown to reduce the effectiveness of the combined pill or progesterone-only pill (6–8).
Nausea and vomiting can interfere with your pill
Common side effects of GLP-1 medications include nausea and vomiting (7,9). This can also affect how well the pill is absorbed and how well it works.
For the combined pill, if you vomit less than 3 hours after taking your pill, take another pill right away and continue the rest at your usual time.
For Natazia (estradiol valerate and dienogest), the timeframe is up to 4 hours. The same applies to Zoely (nomegestrol acetate and estradiol), which is available in some European and South American countries but not in the US (10). If you keep being sick, use condoms or another backup birth control method during sex until you’ve had 7 days in a row without vomiting (10).
For most progestin-only pills, vomiting or severe diarrhea within 3 hours of taking a pill can mean your body has not fully absorbed the dose. This can limit the contraceptive effect. Keep taking your pills as scheduled, but use condoms or another backup method during sex until 2 days after you’ve recovered.
If you miss a pill by more than 3 hours, take it as soon as you remember and use backup contraception for the next 2 days. Some progestin-only packs have 24 active pills and 4 inactive pills, which allows for more flexibility—you can take a missed pill within 24 hours and still be protected (11).
Other types of birth control, like the IUD, vaginal ring, patch, hormonal implant, or injection, are not affected by vomiting or diarrhea, and GLP-1 medications do not change how well they work (7).
What do early studies show about GLP-1s, pregnancy, and fertility?
Early research has not found an increased risk of major developmental issues during early pregnancy from GLP-1 exposure. This is reassuring, but the data in humans is still limited, and larger studies are needed to fully understand how these medications affect fertility and pregnancy (12,13). Some animal studies, however, have raised concerns about growth and development issues in the offspring (14,15).
As a precaution, it’s advised to avoid GLP-1 medications in the weeks before trying to get pregnant and during pregnancy. This “washout” period helps ensure the drug is out of your system. The recommended timelines are:
Ozempic and Wegovy: stop at least 2 months before trying to get pregnant
Mounjaro: stop at least 1 month before
If you find out you’re pregnant while taking a GLP-1 medication, speak with your healthcare provider. GLP-1s are not recommended during pregnancy, but newer studies show they don’t seem to increase the chance of developmental issues (2,7,13).
More research is needed to fully understand how GLP-1 medications affect pregnancy and pregnancy planning, so using reliable contraception while taking this type of medication is suggested (2).
What do studies show about GLP-1s and oral contraceptives?
Research suggests that semaglutide, the active ingredient in Ozempic, Wegovy, and Rybelsus, does not significantly affect how the body absorbs oral contraceptives. This is also true for other GLP-1 medications such as exenatide (Bydureon BCise), liraglutide (Saxenda, Victoza), or dulaglutide (Trulicity). So if you’re using one of these with the birth control pill, your protection should still work (6,8).
However, it’s different for other GLP-1 medications. Tirzepatide (Mounjaro) has been shown to reduce how much oral contraceptives the body absorbs by around 20% (8). Using a backup birth control method for 4 weeks after starting or increasing the dose is advised. Alternatively, the manufacturer advises switching to a non-oral contraceptive, such as an IUD, patch, or implant (7,8,14).
If you’re using a GLP-1 medication and rely on oral contraception, it’s a good idea to check in with your healthcare provider about the best option for you.
What birth control options are good alternatives while on GLP-1s?
If you’re using a GLP-1 medication and want to avoid worrying about whether your birth control pill is still effective, you can switch to a non-oral option. Methods like the IUD, implant, patch, ring, or injection are not affected by GLP-1s and are considered reliable; no extra precautions are needed.
Here are some options:
IUD
When it comes to choosing an IUD, you have two options: hormonal or non-hormonal. Both are safe forms of long-acting reversible contraception.
Once inserted, they work for years with minimal upkeep—just the occasional thread check. Hormonal IUDs can lighten or stop periods, while the non-hormonal (copper) IUD is hormone-free but may cause heavier periods for some (16).
Implant
The implant is a thin, matchstick-sized rod placed under the skin of your upper arm. It releases a steady dose of progestin to prevent pregnancy and works for up to 3 years.
Once inserted, you don’t need to think about it, apart from getting it replaced on time. Some people may have unpredictable bleeding, especially at first, but for many, periods become lighter or go away altogether (16).
Injection (the shot)
The birth control injection (also called the shot) is a progestin-only method you receive every 3 months. As with other progestin-only options, it doesn’t contain estrogen and may be suitable for people who cannot use estrogen-based contraception.
Some people may experience unpredictable bleeding, particularly when they start this method (17).
Patch or vaginal ring
If you’re happy with how your combined oral pill works for you, but prefer a non-oral option, the patch or vaginal ring might be a good fit. Both are types of combined hormonal contraceptives that deliver estrogen and progestin, just like the combined pill, but through the skin or vaginal lining, not the digestive system.
Both are effective and low-maintenance options. The patch is changed weekly, and the ring stays in for 3 weeks, followed by a one-week break. They work similarly to the pill to regulate cycles and prevent ovulation (18).
Talking to your healthcare provider can help you find the contraceptive option that fits your needs best, especially while using GLP-1 medication. There are different options to choose from depending on where you are in your family planning journey, your preferences, and personal health factors.
What to ask your healthcare provider
Your healthcare provider can help you find the safest and most effective option for your situation. Consider asking questions like:
Is my current birth control a good fit for me while taking GLP-1s?
What is the safest birth control option for me, considering my personal factors and weight?
I’m planning a pregnancy after my GLP-1 treatment. What contraceptive option should I use in the meantime?
Do I need a ‘wash-out’ period before trying to get pregnant after stopping my GLP-1?
What should I do if I vomit shortly after taking my pill?
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Key takeaways
GLP-1 medications can affect birth control differently depending on the type you use. If you’re about to start or already use a GLP-1, it’s important to talk with your healthcare provider to make sure your contraception is still the best fit for you.
In the Clue app, you can track your birth control method alongside your cycle to spot patterns and see whether your current method is the right fit for you. Clue helps turn your data into a powerful tool for navigating your cycle, helping you better understand your body.
FAQs
Is it safe to take Ozempic and birth control together?
There is no evidence that Ozempic makes your birth control pill less effective. However, ethinyl estradiol, the estrogen component in many combined hormonal contraceptives, can slightly influence how your body manages blood sugar. This might affect how well Ozempic works, especially if you’re using it to manage diabetes. This doesn’t change your level of contraceptive protection, but your healthcare provider may want to monitor your blood sugar more closely and adjust your medication if needed (7,19).
Do GLP-1 meds cause birth control to fail?
Most GLP-1 medications, like Ozempic, don’t affect the birth control pill. But Mounjaro can lower how much of the pill gets absorbed, so backup contraception is advised for 4 weeks after starting or increasing the dose (7).
Another thing to keep in mind: GLP-1s can cause side effects like nausea or vomiting, which can limit the absorption of your pill. You may need to take another pill or use backup contraception (9,10). It’s a good idea to check in with your healthcare provider to make sure your contraception is covered.
Can Ozempic make birth control less effective?
Ozempic is not expected to reduce the effectiveness of birth control pills. So far, research has shown that Ozempic doesn’t significantly interfere with how oral contraceptives are absorbed (7,8).
However, Ozempic can cause nausea or vomiting, especially when you first start taking it. If you vomit within a couple of hours after taking your pill, your body might not have absorbed it. So follow the missed pill guidance in your pill’s instructions or use backup contraception to be safe (9,10).
What are "Ozempic babies?"
“Ozempic babies” is a term used to describe surprise pregnancies in people taking GLP-1 medications like Ozempic, sometimes even while on birth control or after past fertility struggles. Weight loss from GLP-1s can restore ovulation, which may lead to unexpected fertility (20).
While Ozempic doesn’t seem to affect birth control pills, Mounjaro may reduce absorption—so backup contraception is advised for 4 weeks after starting or increasing the dose. Because there is limited data on pregnancy safety, it’s best not to try to get pregnant while taking GLP-1s and to use effective contraception. (7,20–22).
