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Prescription weight loss that puts you first
Reviewed by Craig Primack, MD, FACP, FAAP, FOMA
Written by Lauren Panoff
Published 07/16/2024
Updated 08/11/2024
While polycystic ovary syndrome (PCOS) can have a number of symptoms, one of the most common complaints is that it can make losing weight more difficult. But there may be good news when it comes to the weight loss medication Ozempic® and PCOS.
Ozempic — the brand name for a medication called semaglutide that’s approved to treat type 2 diabetes — may positively affect certain PCOS symptoms and support weight loss goals.
We’re taking a closer look at the potential of Ozempic for PCOS.
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PCOS is a common hormone disorder in which the ovaries are enlarged and develop numerous small, fluid-filled cysts around the eggs. It affects an estimated five to six million women in the United States, including 10 to 20 percent of women of reproductive age.
The exact causes of PCOS aren’t fully understood. However, it’s thought that the hormonal changes involve factors like genetics, environmental influences, insulin resistance, and hyperandrogenism (higher testosterone levels).
Potential risk factors for PCOS can include a family history of PCOS, a person’s race, experiencing weight gain or obesity, prediabetes, or type 1 or 2 diabetes.
Though PCOS can affect women differently, some common signs and symptoms of PCOS are:
Irregular periods: Many women with PCOS report having irregular, infrequent, or longer-than-normal menstrual cycles.
Excess androgen levels: Increased testosterone, a predominantly male sex hormone, can lead to increased hair growth on the face, chest, abdomen, and back, as well as issues like acne, oily skin, and thinning hair.
Skin changes: PCOS can lead to acanthosis nigricans, or the darkening of the skin, particularly along neck creases, in the groin, and underneath breasts. It may also cause skin tags around the armpits or neck area.
Insulin resistance: Having PCOS increases your risk of developing type 2 diabetes and may manifest through symptoms like fatigue, hunger, and difficulty concentrating. Many women with PCOS experience difficulty regulating blood sugar levels, which can lead to increased insulin production.
Fertility issues: It’s not uncommon to experience difficulty conceiving or infertility due to irregular ovulation or anovulation (lack of ovulation).
Additionally, women with PCOS may experience unintentional weight gain, most often around the abdomen, which may be harder to lose despite changes in nutrition and exercise habits.
In fact, research has found that over 50 percent of women with PCOS deal with excess weight or obesity. This can be frustrating, leading many women with PCOS to wonder what they’re doing wrong (spoiler alert: probably nothing!).
Ozempic is approved for the management of type 2 diabetes, but it has shown promising results in improving insulin sensitivity, reducing body weight, and improving menstrual regularity in women with PCOS.
Ozempic belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. It helps increase insulin and decrease glucagon release, improving blood glucose levels.
As such, these types of medications could play a crucial role in the therapeutic landscape of PCOS, offering a multifaceted approach to addressing both the metabolic and reproductive aspects of the disorder.
Currently, there are no FDA-approved PCOS medications. Instead, oral contraceptives (birth control pills), antiandrogens, insulin sensitizers, and ovulation inducers are often used off-label to treat the condition.
One study found that GLP-1 medications like Ozempic helped improve various metabolic parameters of women with PCOS, such as weight loss, insulin sensitivity, and more normalized hormonal balance. They also appeared to be associated with improvements in menstrual regularity and fertility.
In another recent study, 27 women with obesity and PCOS who didn’t find success in weight loss through lifestyle modification were treated with semaglutide, receiving a 0.5 mg injection once a week.
After three months of weekly treatment, the average body weight reduction was approximately 15 pounds, with minimal side effects reported. Overall, around 80 percent of those with obesity saw at least a five percent reduction in body weight.
This is significant for several reasons.
International guidelines for the treatment of obesity among women with PCOS recommend an initial weight loss of at least five to 15 percent to improve hormonal imbalances, menstrual regularity, ovulation, insulin resistance, and elevated blood fats.
To increase the chances of becoming pregnant and having a healthy pregnancy, at least 10 percent weight loss is generally recommended.
Further, another study on insulin sensitivity in women with PCOS suggested that combining GLP-1 drugs with metformin — a diabetes medication sometimes used off-label for weight loss — may work even better than either one alone.
More clinical trials are needed to understand the potential of semaglutide and Ozempic for PCOS and weight loss. However, the currently available evidence suggests that Ozempic for PCOS — and possibly even the addition of diabetes drug metformin — may support many women facing difficulty losing a substantial amount of weight.
Ozempic is only approved by the FDA for treating type 2 diabetes. It’s not FDA-approved for weight loss. However, some providers prescribe it off-label (meaning, for reasons other than its approved purpose) for obesity treatment.
If you’re interested in exploring weight loss medications or other options to support your weight loss goals, speak with your healthcare provider. They can help determine what’s safe and appropriate for you.
Does Ozempic help PCOS? Maybe. Early research suggests that Ozempic may offer much-needed support for some women with PCOS who are trying to lose weight.
Either way, it’s important to prioritize healthy lifestyle habits as the foundation for pursuing your weight loss goals. We like to focus on the four pillars of healthy living, which can support both weight loss goals and PCOS symptom management.
Nutrition is foundational to weight loss and long-term well-being. While maintaining a calorie deficit (generally around 500-750 calories per day, either from less food intake, more exercise, or both) is a key component of weight loss, optimal nutrition is even more important.
Do your best to choose nutrient-dense foods most of the time, including an array of fruits, vegetables, nuts, seeds, whole grains, legumes, and other lean proteins. Avoid ultra-processed foods like sugary beverages, potato chips, pastries, and hot dogs, which have been linked to higher risks of obesity as well as high cholesterol and high blood pressure.
Regular exercise helps your body shed extra pounds, helps moderate blood pressure, and reduces your risk of chronic conditions like cardiovascular disease, diabetes, and certain cancers. It’s also great for your mental health, as physical activity releases endorphins — aka “happy hormones” — that boost your mood.
Experts recommend a minimum of 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise on a weekly basis. Additionally, it’s suggested to do resistance training involving all major muscle groups at least twice a week. For weight loss, the aerobic activity recommendation increases to 225 to 420 minutes of moderate-intensity exercise per week.
Aim for daily movement through activities you enjoy. This might include doing martial arts, swimming laps, riding your bike, lifting weights at the gym, joining a group fitness class, or taking your dog for a brisk walk.
Sleep is a core aspect of your health and wellness. It’s your body’s designated time for rest, rejuvenation, and repair. And as it turns out, sleep affects weight loss, too.
When you don’t catch enough Z’s, it can throw your appetite-regulating hormones out of balance and make it more difficult to ignore less healthy cravings.
Shoot for seven to nine hours of quality sleep per night. If this sounds challenging, start by creating a consistent sleep-wake schedule. Incorporate blackout curtains, cozy pajamas, soft bedding, and a white noise machine if needed.
It’s also helpful to avoid using technology, eating a large meal, intense exercise, caffeine, and alcohol close to bedtime.
Staying hydrated is essential for everyday bodily processes, like digestion, electrolyte and pH balance, and temperature regulation.
It’s also an important component of weight loss and healthy weight management. Drinking water helps promote the breakdown of fat, curb your appetite, and prevent overeating, especially when you hydrate right before and during meals.
Our best advice is to keep a reusable water bottle with you all day to refill as needed. If you get bored of plain water, try infusing it with lemon wedges or cucumber slices, or swap it for herbal tea or unsweetened seltzer.
Ozempic has proven successful in helping many women (and men) achieve their weight loss goals when paired with a healthy lifestyle. But does Ozempic work for PCOS weight loss? Here’s what to keep in mind when it comes to Ozempic for PCOS weight loss:
We don’t have all the information yet. While we need more data regarding the benefits of Ozempic for women with PCOS, what we know so far is promising. More research on this topic is on the horizon but hasn’t been released yet.
Practice healthy lifestyle changes. Other daily habits — like good nutrition, regular exercise, hydration, and better sleep — are important for general wellness, weight loss, and possibly even PCOS symptom management.
Seek medical guidance. Before adding anything new to your weight loss routine, such as Ozempic or other GLP-1 receptor agonists, speak with your healthcare provider or endocrinology specialist to discuss treatment options.
If you’re interested in exploring weight loss drugs and your personalized weight loss goals, take our free online assessment to connect with a licensed healthcare provider.
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