How GLP-1 Medications Can Help with PCOS

Polycystic ovary syndrome (PCOS) is a common condition, affecting around 10% of women in the UK. It can cause irregular periods, insulin resistance, acne, excess hair growth, and weight gain. Early research suggests that glucagon-like polypeptide-1 (GLP-1) blocker medications, such as Mounjaro and Wegovy, may help manage some PCOS symptoms by supporting long-term weight loss.

PCOS is linked to abnormal hormone levels and often runs in families. Many people with PCOS have high insulin levels and are resistant to it, meaning the body produces more insulin than it needs and cannot use it effectively. Insulin resistance is also linked with weight gain and metabolism. Because GLP-1 medications improve insulin resistance and promote weight loss, they are being explored as potential treatments for PCOS.

PCOS makes weight loss difficult because it disrupts the balance of hormones, like insulin and testosterone, and causes inflammation in the body. These changes increase appetite, promote fat storage, and make losing weight harder than usual.

How PCOS affects metabolism

There are 3 main factors that make weight loss more difficult with PCOS:

Losing just a small amount of weight, like 5 to 10% of your current weight, can improve metabolic, reproductive and psychological outcomes in people with PCOS.

GLP-1 medications do not treat PCOS directly, but they promote weight loss and improve how your body uses insulin (insulin sensitivity), which are 2 key factors that help reduce PCOS symptoms.

GLP-1 receptor agonists work by mimicking the effects of a naturally produced hormone, GLP-1, to:

• slow stomach emptying
• reduce appetite
• keep you feeling fuller for longer
• improve insulin release
• lower blood sugar

These effects lead to steady and meaningful weight loss over time.

Common GLP-1 medications for weight loss

The main GLP-1 weight loss injections available in the UK are:

• Mounjaro (tirzepatide)
• Wegovy (semaglutide)
• Nevolat (liraglutide)

Let’s look at how well tirzepatide vs semaglutide vs liraglutide can support PCOS.

Mounjaro

Mounjaro contains the active ingredient tirzepatide, which is a dual agonist because it binds to both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. In one study, once-weekly tirzepatide injections given to PCOS patients resulted in an average weight loss of 9.5%, as well as an improvement in symptoms such as irregular periods, insulin resistance, and ovarian cysts. Mounjaro PCOS injections could be promising for managing the condition and its symptoms in the future.

Wegovy

The active ingredient in Wegovy is semaglutide, a GLP-1 receptor agonist. After 3 months, semaglutide helped 80% of obese PCOS patients lose at least 5% of their starting body weight. Those who continued treatment for a further 3 months lost, on average, 11.5kg, and 80% reported their menstrual cycles had returned to normal.

Can you take Ozempic for PCOS?

Ozempic contains semaglutide, the same active ingredient as Wegovy, but in different doses. However, in a 2023 study, participants were given 0.5mg of semaglutide per week, and both Ozempic and Wegovy are available in that dose. Ozempic is a type 2 diabetes medication, rather than a weight loss medication. So it might help if you have both diabetes and PCOS, and your doctor thinks it’s a good choice over other diabetes treatments.

Nevolat

Liraglutide is a daily GLP-1 injection, available as Nevolat and previously under the brand name Saxenda. A 2014 study found that liraglutide treatment for a minimum of 4 weeks in overweight or obese individuals with PCOS resulted in an average weight loss of 9kg and 81.7% lost at least 5% of their starting body weight. Later research has shown that liraglutide can improve ovulation (egg release) in PCOS.

Availability and prescription rules in the UK

* people with an ethnic background that increases the risk of obesity related complications can start any of the licensed weight loss injections with a BMI of 27.5 or above

Weight loss medications like Mounjaro are not licensed specifically for PCOS. Mounjaro is licensed for weight management and type 2 diabetes. However, there is evidence that GLP-1s can help manage PCOS symptoms by promoting weight loss, improving periods, reducing insulin resistance, and even supporting fertility.

Some doctors may prescribe GLP-1 medications for people with PCOS who also meet the criteria needed to qualify for weight loss treatment. For example, if you have PCOS and a body mass index (BMI) of:

• 30 or above
• 27 or above, as PCOS can be considered a weight-related health condition

If you have PCOS and are struggling to lose weight with diet and exercise alone, speak to a doctor to find out if weight loss injections may help you.

Other medications that help with PCOS

Several other medications may be prescribed to manage PCOS, including:

There are several lifestyle changes you can make to help manage PCOS symptoms and support weight loss. The lifestyle and nutrition changes you should make focus on eating balanced meals, getting regular exercise, and managing stress. These changes can help manage symptoms regardless of whether you are taking GLP-1s.

Some of the things you can do include:

1. Reduce your carbohydrate intake

Lowering your carb intake can be helpful if you have PCOS, but you should avoid cutting them out completely because they are an important energy source. Instead, choose low glycaemic index (GI) foods that raise your blood sugar levels gradually, such as wholegrains, vegetables, and some fruits.

2. Eat more fibre and protein

Fibre and protein are great ways to help keep you feeling satisfied, making you less likely to snack or overeat, and are good for blood sugar control. Choose foods like:

• beans
• pulses
• oats
• nuts and seeds
• eggs
• Greek yoghurt
• lean meat

3. Eat more healthy fats

Healthy fats, such as omega-3s, can help balance hormones, improve insulin sensitivity, and reduce inflammation. Healthy fats include:

• oily fish (salmon, herring, mackerel, sardines)
• avocados
• olive oil
• nuts

4. Try fermented foods

Fermented foods contain live, friendly bacteria that support the gut microbiome, help control inflammation, and support metabolic health. Some research suggests that an imbalanced gut microbiome can make PCOS symptoms worse. Fermented foods include:

• yoghurt
• kefir
• sauerkraut
• kimchi

5. Reduce your intake of processed and sugary foods

Processed and sugary foods can cause spikes in your blood sugar levels, making PCOS symptoms worse. Avoid or limit:

• fried foods
• processed snacks
• fatty meats, such as burgers and sausages
• sugary treats and drinks

6. Exercise regularly

Regular physical activity is a great way to improve insulin resistance and body composition. Combining moderate-intensity exercise, like walking, swimming, or cycling, with strength training and aiming for 150 minutes of regular exercise each week is beneficial.

7. Prioritise good sleep

Sleep is crucial for balancing hormones, such as cortisol and insulin. Aim to get 7 to 9 hours of sleep each night and keep to a regular sleep-wake cycle to promote good metabolic health.

8. Reduce stress

Chronic stress can increase androgen levels, like testosterone, disrupting hormonal balance. Helpful strategies include:

• breathing exercises
• meditation
• yoga
• spending time outdoors

GLP-1 medications can support people with PCOS by helping them lose weight, reduce insulin resistance, and improve symptoms like irregular periods. However, weight loss medications, like Mounjaro and Wegovy, are not currently approved treatments for PCOS alone and should be combined with lifestyle changes for the best results.

Is Ozempic used for PCOS?

Ozempic is licensed for type 2 diabetes, not PCOS. Some doctors may prescribe it off-label to help people with PCOS lose weight if they meet the criteria and have struggled to lose weight with diet and exercise alone.

Can I get PCOS weight loss injections on the NHS?

Yes, it may be possible to get PCOS weight loss injections on the NHS if you have a BMI of 35 or more or a BMI above 30 and certain health conditions. PCOS alone does not qualify you for GLP-1 treatment on the NHS.

What is the best medication for PCOS weight loss?

There is no best medication for PCOS because it will depend on your individual needs. Metformin is commonly prescribed to improve insulin resistance, while GLP-1 agonists may be given to manage weight. Combined contraceptive pills may also be prescribed to help balance reproductive hormones and regulate the menstrual cycle.

Is Mounjaro or metformin better for PCOS?

Neither Mounjaro nor metformin are better for all cases of PCOS. The best choice will depend on your individual health needs and treatment goals. If you are looking to manage your blood sugar levels and insulin resistance, metformin may be recommended, but if you are looking to manage both your weight and blood sugar, Mounjaro may be more suitable.

Does Mounjaro help with fertility?

Mounjaro is not a fertility medication, but it may indirectly support ovulation and regular periods. It does this by improving insulin sensitivity, reducing inflammation, and managing weight. Research suggests that women who take part in weight loss programmes before undergoing in vitro fertilisation (IVF) are 47% more likely to get pregnant naturally than those who receive no or minimal weight loss support.