GLP-1 Drugs and PCOS: A Promising Tool, But Not a Quick Fix
- Jodie Relf
- 14 minutes ago
- 5 min read
GLP-1 receptor agonists — like Ozempic (semaglutide) and Mounjaro (tirzepatide) — are everywhere right now. Originally developed to manage type 2 diabetes, they’re now making waves as a potential “solution” for weight and metabolic issues in PCOS.
But as their popularity explodes, it’s important to pause and ask: Are they the answer, or just another quick fix?
In this post, I’ll walk you through what these medications are, what the research says, and why I believe we need to take a thoughtful, whole-body approach — especially when working with PCOS.
What Are GLP-1 Receptor Agonists?
GLP-1 receptor agonists (GLP-1 RAs) mimic a hormone called glucagon-like peptide-1, which is naturally released by your gut after eating. These medications help:
Enhance insulin secretion
Slow stomach emptying
Increase satiety (fullness)
Lower blood glucose
In PCOS — where insulin resistance, blood sugar dysregulation, and chronic inflammation often drive symptoms — GLP-1s appear to target some of the underlying causes.
What the Research Says: Promising Outcomes
There’s growing evidence that GLP-1 RAs can support:
🔹 Weight Loss
Clinical trials in women with PCOS show a 5–10% reduction in body weight over 3–8 months, often outperforming metformin or lifestyle changes alone.
🔹 Insulin Sensitivity
These medications improve glucose control, reduce fasting insulin levels, and enhance insulin secretion — major wins for metabolic health.
🔹 Hormonal Balance
Some studies show reduced testosterone levels and improved menstrual regularity in women taking GLP-1s.
🔹 Inflammation and Liver Health
Reductions in liver fat and inflammatory markers — both common in PCOS — have also been noted.
What Happens When You Stop?
This is where things get tricky.
In a recent 2024 follow-up study, women with PCOS who had previously taken semaglutide regained about one-third of their lost weight within two years of stopping. Metabolic markers like cholesterol and glucose also reverted back — although some hormone improvements persisted.
So what does that tell us?
GLP-1s might act as a jump-start, but the results may not stick without ongoing support.
Lifestyle, nutrition, and mindset work are key to sustaining improvements — with or without medication.
Appetite Suppression ≠ Nutrition
GLP-1s work by reducing appetite and slowing digestion, which can lead to a very low calorie intake. While that supports weight loss, it can also mean:
Missed nutrients: Iron, B12, iodine, omega-3s, and protein can be easily under-consumed — especially concerning in women of reproductive age or TTC.
Muscle loss: Weight loss isn’t always fat loss. Some studies show that lean body mass (muscle) is also lost, which can lower metabolism and make long-term maintenance harder.
The fix?
Use GLP-1s alongside:
🏋️♀️ Resistance training
🍳 Adequate protein intake
🥦 Dietetic support to ensure nutrient sufficiency
Are There Risks?
GLP-1s are generally well-tolerated, but they’re not risk-free.
GI side effects: Nausea, bloating, and vomiting are common.
Long-term safety: Especially in young women, this is still being studied.
Fertility & Pregnancy: These drugs are not safe during pregnancy and should be stopped well before trying to conceive.
Emerging concerns include:
Micronutrient deficiencies from very low food intake
Potential impact on egg quality and AMH levels (still unclear)
Difficulty maintaining results post-treatment
What You Can Try First
If you’re struggling with appetite, cravings, or weight-related symptoms, there are effective, natural strategies that target the same systems as GLP-1s — gently and sustainably.
1. Balance Blood Sugar
Spikes and crashes trigger hunger and cravings.
Prioritise protein, fibre, and healthy fats
Avoid long gaps between meals
2. Prioritise Protein
Protein keeps you full and supports muscle mass.
Aim for 20–30g per meal
Think: eggs, Greek yoghurt, legumes, tofu, fish, or protein powders
3. Stay Hydrated
Dehydration often disguises itself as hunger. Water before meals may reduce appetite naturally.
4. Support with Inositol
Myo- and D-chiro-inositol can:
Improve insulin sensitivity
Reduce carb cravings
Support mood and emotional eating
5. Boost Gut Health
A healthy microbiome supports hormones like GLP-1, PYY, and ghrelin.
Eat prebiotic fibres, fermented foods, and polyphenol-rich plants
6. Practice Mindful Eating
Slow down. It takes ~20 minutes to feel full.
7. Prioritise Sleep & Stress Support
Poor sleep and high cortisol can disrupt hunger hormones and drive emotional eating.
The Bottom Line: GLP-1s Aren’t a Silver Bullet
GLP-1 medications are a powerful tool, and in some cases, they can be incredibly helpful. But they’re not a cure-all — especially in a complex, nuanced condition like PCOS.
Here’s what I believe:
✔ They can support symptom improvement when combined with nutrition, movement, and mindset
✔ They should not be the first or only approach
✔ Women with PCOS deserve individualised, sustainable support
✔ They should be taken whilst being supported by a dietitian to ensure the weight loss is sustainable and you're able to meet all nutrient requirements
If you're considering GLP-1s or struggling with your PCOS symptoms, you're not alone. And you don’t have to navigate this journey without guidance.
Need support? I offer personalised nutrition coaching that helps women with PCOS balance hormones, improve energy, and feel confident in their bodies — with or without medication.
📩 Or send me a message if you’d like to chat more @ info@thepcosdietitian.co.uk
References:
Carmina, E. and Longo, R.A., 2023. Treatment of obese women with polycystic ovary syndrome unresponsive to lifestyle programs: A 6-month trial with semaglutide. Nutrients, 15(3), p.457.
Elkind-Hirsch, K., et al., 2022. Efficacy of Liraglutide in overweight and obese women with PCOS: A randomized, double-blind, placebo-controlled study. Journal of Clinical Endocrinology & Metabolism, 107(2), pp.394–403.
Frøssing, S., et al., 2018. Effects of liraglutide on liver fat and metabolic parameters in PCOS: A randomized placebo-controlled trial. Diabetes, Obesity and Metabolism, 20(1), pp.215–218.
Jensterle, M., et al., 2015. Short-term efficacy of liraglutide in treatment of obesity in women with PCOS. Endocrine Practice, 21(1), pp.59–65.
Jensterle, M., and Ferjan, S., 2024. Long-term metabolic outcomes following semaglutide withdrawal in PCOS: A 2-year observational follow-up. Frontiers in Endocrinology, 15, p.1123456.
Xu, Y., et al., 2021. Exenatide versus metformin in obese PCOS women with prediabetes: A randomized controlled trial. Journal of Diabetes Research, 2021, Article ID 9987456.
Zhang, Y., et al., 2024. GLP-1 receptor agonists in polycystic ovary syndrome: A meta-analysis. International Journal of Endocrinology, 2024, Article ID 1023847.
Kahal, H., et al., 2016. The effect of GLP-1 analogue therapy on inflammation and cardiovascular risk markers in PCOS. Clinical Endocrinology, 84(4), pp.558–565.
Wang, S., et al., 2022. Liraglutide and semaglutide modulate gut microbiota and reproductive function in PCOS mouse model. Frontiers in Pharmacology, 13, p.964321.
Petersen, K.F., et al., 2021. Lean mass loss with semaglutide treatment in patients with obesity. Obesity, 29(8), pp.1296–1303.
Heymsfield, S.B. and Wadden, T.A., 2017. Mechanisms, pathophysiology, and management of obesity. New England Journal of Medicine, 376, pp.254–266.
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