Understanding the impact of weight loss medications on female reproductive health

In recent months, the efficacy of contraception for people taking weight loss medications has been questioned, as several women claim to have gotten pregnant despite using oral contraceptives.

Despite the lack of evidence on whether the drug can interfere with some birth control methods, the conversation on how they might affect other aspects of female reproductive health is ongoing.

Here, Kiran Jones, Clinical Pharmacist at Oxford Online Pharmacy, discusses how weight loss medications like Mounjaro and Wegovy can impact everything from periods to sexual desire, fertility and pregnancy, and why it might soon be introduced as an effective treatment for female health issues like Polycystic Ovary Syndrome (PCOS).

Irregular menstrual cycles 

Weight loss pills can alter metabolism and hormonal balance, which can sometimes result in irregular menstrual cycles and potentially even broader reproductive health issues.

That’s because the GLP-1 receptors target brain pathways or change how the body stores energy, leading to rapid weight or fat loss. Since reproduction requires substantial energy, this can disrupt functions like menstruation.

Monitoring menstrual cycles and seeking professional advice is vital when using these treatments.

Unusual ovulation or fertility patterns 

As the medications induce an energy deficit, this signals the brain’s hypothalamus – the brain’s hormone regulating center – to suppress gonadotropin-releasing hormone (GnRH) secretion.

This can lead to irregular or absent ovulation, reducing the chances of conception by 30-40 percent as no eggs are available for fertilization.

Additionally, reduced body fat (below 17%) can also impact oestrogen levels, while rapid weight loss triggers physiological stress, further deprioritizing reproduction.

For those trying to conceive after weight loss treatment, delayed conception may occur. Some sources suggest it’s best to stop treatment at least two months before attempting to conceive, and it is always important to consult a healthcare professional if you are planning to get pregnant.

Improved insulin sensitivity and symptoms for PCOS 

In the UK today, 1 in 5 women is thought to be affected by Polycystic Ovary Syndrome – a hormonal disorder that can lead to insulin resistance, weight gain, and reproductive challenges.

A study is underway to investigate whether Semaglutide, the active ingredient in weight loss medications like Wegovy, could improve insulin sensitivity and relieve symptoms of PCOS.

That’s because these enhance the body’s response to insulin, lowering blood sugar levels and reducing insulin resistance. This improved sensitivity can aid weight loss and help regulate hormonal imbalances, easing many symptoms of PCOS.

For women hoping to conceive, these treatments may restore regular ovulation, significantly improving the chances of conception.

While the research is promising, it’s essential to consult a healthcare professional to develop a tailored treatment plan and avoid self-administration.

Changes in sexual desire 

Weight loss medications can have a positive impact on body image and sexual wellbeing, particularly for individuals struggling with self-esteem and confidence due to weight-related concerns.

By promoting weight loss and improving physical health, these treatments often lead to a more positive self-image, which can enhance intimacy and sexual satisfaction. Additionally, improved hormonal balance from weight loss can boost libido, particularly for individuals with conditions like PCOS.

However, some medications may initially affect sexual desire or performance. Monitoring changes, maintaining open communication with partners, and seeking guidance from healthcare professionals are essential steps to address any concerns and optimize sexual health.