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GLP-1s and your cycle: The impact of weight loss medications on hormonal health
Expert Q&A with Dr. Charis Chambers
GLP-1 medications, like Ozempic, Wegovy, and Mounjaro, have become increasingly popular for weight management, but what is their impact on the menstrual cycle and hormonal health issues?
In this expert Q&A with Clue’s Chief Medical Officer, Dr. Charis Chambers, she explains what’s currently known about GLP-1s and reproductive health, and how period tracking apps can be useful tools to help monitor any subtle hormonal changes.
Key takeaways:
GLP-1 medications are primarily used for weight loss, but are increasingly being explored in relation to PCOS and perimenopause
Early evidence (mainly in women with obesity and PCOS) suggests GLP-1s may improve insulin resistance and support more regular menstrual cycles and ovulation
There is currently limited research on how GLP-1 medications affect periods, fertility, PMS, or menopause symptoms in the wider population
Period tracking apps like Clue may help users monitor cycle and symptom changes while using GLP-1 medications
1. How are women using GLP-1 medications for weight loss, and what trends are you seeing?
The trends I’m seeing are women using GLP-1 medications who have historically struggled with weight loss resistance or hit a wall in their weight loss journeys.
Many of these women have already implemented nutritional changes as well as regular exercise, and their GLP-1 medication has allowed them to achieve the results that these initial changes could not.
The liberation and empowerment have been inspiring to witness.
2. We know GLP-1s are mostly used for weight loss, but how do the drugs (like Ozempic, Wegovy, Mounjaro) interact with the endocrine system beyond appetite and metabolism?
GLP-1 medications also affect the heart, brain, and immune system, because GLP-1 receptors are found throughout the body, including in the heart, brain, fat, and muscles.
In the heart and blood vessels, these drugs can help lower blood pressure, improve how blood vessels work, and reduce inflammation.
In fat and muscle, they make the body more sensitive to insulin, lower inflammation, and help the body process fats more efficiently. This can reduce deep belly fat and improve muscle health. They also help protect the brain by lowering inflammation there.
3. Are there any known effects of GLP-1s on female reproductive hormones?
Studies show that GLP-1 medications can affect reproductive hormones in women with obesity and polycystic ovary syndrome (PCOS). In these women, the drugs have been found to lower testosterone levels, help make periods more regular, and increase natural pregnancy rates.
These benefits are thought to come from weight loss, better insulin control, and possibly direct effects on how the ovaries and brain regulate hormones.
GLP-1 receptors are also found in the ovaries, uterus, and pituitary gland, suggesting these drugs may play a role in controlling reproductive hormones.
4. What data currently exists on the impact of GLP-1s on menstrual cycles, ovulation, fertility, or menopause symptoms?
Studies in women with both obesity and PCOS show that GLP-1 medications can have positive effects on menstrual cycles, ovulation, and fertility.
Research and pooled data from multiple studies suggest these drugs can increase natural ovulation and pregnancy rates, especially when used together with metformin (a medication used to manage type 2 diabetes).
When it comes to GLP-1s and pregnancy, early evidence hints that GLP-1s might help the uterus prepare for pregnancy by reducing inflammation and improving blood flow.
For menopause, there isn’t enough solid research showing how GLP-1 medications affect these symptoms or hormone levels in women.
5. Have you noticed trends or changes in menstrual cycle patterns among users who take GLP-1s?
I’ve definitely heard reports of improved menstrual cycles from users taking GLP-1s, specifically the return of regular menstrual cycles in people who may have skipped their periods due to anovulation (ovulation does not occur) in the setting of PCOS and obesity.
6. Are certain symptoms (e.g., cycle length changes, bleeding patterns, PMS severity) more common than others among GLP-1 users?
There isn’t much large-scale research looking at how GLP-1 medications affect menstrual or reproductive symptoms in the general population, so more studies are needed.
So far, no specific menstrual or reproductive issue has been identified as a common side effect of these drugs. Reviews and safety studies have found only a few isolated reports of menstrual or reproductive changes, meaning that shifts in cycle length, bleeding, or PMS symptoms appear to be rare.
In contrast, stomach-related side effects like nausea, vomiting, and diarrhea are much more common than any reproductive or menstrual effects.
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7. How can period tracking apps like Clue help women detect subtle hormonal changes when taking medicines like GLP-1s that clinical trials might not capture?
Clinical trials rarely focus on menstrual or reproductive outcomes. Period tracking apps like Clue can provide a practical tool for women on GLP-1 medications to monitor and detect subtle hormonal changes that clinical studies and general research would likely underreport.
Clue allows users to track a wide range of symptoms, from mood changes to headaches, energy levels, bloating, and more.
This granular, real-time data can reveal even the rarest menstrual cycle-associated symptoms. It also allows for individual insight, which can only be gained from comparing cycle patterns before and after starting GLP-1 medications.
8. How are GLP-1s bridging the gap between metabolic/weight pathways and the hormonal/menstrual cycles world?
GLP-1s aren’t necessary bridging the gap between metabolic and hormonal pathways, but are more so revealing the connection that has always existed. The very reason GLP-1s can affect menstrual cycles, fertility, and more is because these systems have always been inextricably linked. This link has been ignored in the weight loss conversation for far too long.
9. Can GLP-1s accelerate, delay, or mask perimenopause or menopause symptoms?
GLP-1 medications don’t seem to make perimenopause or menopause happen earlier or later or mask its symptoms. There isn’t much research yet on how they affect women in perimenopause or menopause.
Anecdotal reports show that women in midlife are losing weight on GLP-1 medications, and stubborn weight gain is a huge issue for many menopausal women. But more studies are needed, since more and more midlife women are now using GLP-1 medications.
10. Do people need to stop taking GLP-1s if they are trying to conceive?
Women who want to get pregnant should stop taking GLP-1 medications before trying to conceive. Experts recommend this because animal studies show possible harm to the fetus, and there isn’t enough safety data in humans.
Expert societies advise waiting at least 4 weeks after stopping the medication before trying to get pregnant.
It’s also helpful to use a menstrual tracking app like Clue when stopping GLP-1 medications in preparation for pregnancy. These apps can track cycle length, bleeding, and signs of ovulation, giving detailed information that may help identify more subtle cycle changes and support personalized pregnancy planning.
11. Do you see period and cycle tracking apps becoming a standard part of monitoring hormonal health in patients taking new medications?
I believe period tracking apps could and should play a role in the monitoring of hormonal health in patients taking new medications, primarily because these apps collect information over time directly from the person using them, helping to spot trends, unusual events, and individual differences.
Many research studies can’t collect data with the speed, volume, detail, and diversity that the likes of Clue provide.
