Can Ozempic Help with PCOS Symptoms? I Asked an OB/GYN

In addition to their origins as treatment for type 2 diabetes, GLP-1 receptor agonists like Ozempic and Wegovy are often most closely associated with obesity and weight loss. But did you know these medications have shown promise as a treatment for Polycystic Ovary Syndrome (PCOS), a type of hormone imbalance that can cause irregular menstrual periods, excess hair growth, acne and infertility? To learn more about the potential effects of Ozempic on PCOS symptoms, I asked board-certified OB/GYN Dr. Kerry Krauss, MD.

Dr. Kerry Krauss, MD, is a board-certified OB/GYN and Medical Director for Natural Cycles, the first FDA-cleared birth control app. Dr. Krauss received her MD from Thomas Jefferson University and completed her residency at Pennsylvania Hospital. She also holds a bachelor's degree in biology. As an advisor for Natural Cycles, Dr. Krauss helps advance the company’s mission of empowering women to take charge of their health.

Dr. Krauss tells me that while GLP-1 receptor agonists are not currently a first-line treatment for PCOS, many PCOS patients have started taking these medications to help manage the obesity, diabetes or hyperlipidemia (high cholesterol) that can result from PCOS. She tells me, “There has also been some evidence to suggest that GLP-1 medications can be effective in restoring regular menstrual cycles for those with PCOS and lead to lower levels of androgens, even before major weight loss takes place.” She points to a study she was a part of at Natural Cycles, in which 43 percent of women with PCOS who were taking GLP-1 medications reported changes in their menstrual cycles, such as increased cycle regularity and shorter periods, compared with only 27 percent of all women on GLP-1 medications. “While these findings are preliminary, they support what we have seen in the literature, which shows that GLP-1s seem to be very effective for restoring normal periods and ovulation for patients with PCOS,” she explains.

“About 80 percent of women with PCOS have insulin resistance, which can lead to elevated androgen levels, irregular cycles, inflammation, weight gain and even diabetes and certain types of cancer,” Dr. Krauss explains. “By improving insulin sensitivity, GLP-1 medications may help reverse many of these symptoms of PCOS, but more research is needed to understand how much these other symptoms are impacted by GLP-1s.” She adds that the research that does exist so far is promising to suggest that the GLP-1 medications may work better than the treatments we have offered previously. 

She tells me there have been several studies showing the benefits of GLP-1s for PCOS patients as it relates to treatment of obesity and diabetes, but not as many about how GLP-1 medication can affect the menstrual cycles and ovulation. Because of this, she stresses that healthcare providers need to take each patient’s unique history and personal goals into account before considering GLP-1s as part of the PCOS management plan.

Yes. Dr. Krauss notes that any patient who has a personal or family history of medullary thyroid cancer, MEN2 syndrome or a personal history of pancreatitis, type 1 diabetes or gastroparesis should not take a GLP-1 medication. “In addition, anyone with a history of severe depression or suicidal ideation should use caution taking GLP-1 medications,” she says. “Also, if you are trying to conceive, it is recommended you wait at least two months after your last dose of GLP-1 medication before trying to conceive.”

Right now, PCOS alone is not an FDA-approved indication for a GLP-1 medication, but Dr. Krauss asserts that some conditions arising from PCOS are, like obesity and diabetes. Traditionally, she says, PCOS treatments have focused on managing symptoms like irregular cycles and excess hair growth with hormonal therapies and by emphasizing lifestyle changes. “However, these therapies do not always correct the underlying hormonal imbalances that lead to PCOS, and that’s why there is hope among the PCOS community that GLP-1s may be a far more effective therapy than what has been offered previously,” she tells me. “In order for this to happen, we must continue to invest in more research to demonstrate the benefits of GLP-1 medications for PCOS patients. Hopefully, once we do that, we’ll see changes in how GLP-1s are covered by insurance.”