GLP 1 Agonists and PCOS

Weighing Up the Pros and Cons

GLP-1 receptor agonists – such as semaglutide (Ozempic, Wegovy) or liraglutide (Saxenda) – are gaining attention for their effects on weight loss, blood sugar regulation, and insulin resistance. All of these are key issues in PCOS, but these medications were never designed specifically for PCOS. So, how relevant are they, and what does the research say about their benefits and risks to those of us with PCOS?

What are GLP-1 receptor agonists?

GLP-1 (glucagon-like peptide-1) is a hormone naturally produced in the gut, released in response to food, and it plays several important roles - regulating blood sugar, insulin release, appetite and digestion. GLP-1 receptor agonists are medications that mimic the action of this hormone. They were originally developed for type 2 diabetes but are now increasingly prescribed off-label for weight loss and insulin resistance.

GLP-1 agonists work by helping to lower blood glucose by increasing insulin secretion and decreasing glucagon (a hormone that raises blood sugar). They also slow gastric emptying and promote a feeling of fullness, which can lead to reduced food intake and weight loss.

Why are they being used for PCOS?

Some women with PCOS experience insulin resistance, difficulty with weight loss, and increased appetite. There’s a growing body of research suggesting that GLP-1 receptor agonists may improve metabolic, hormonal, and reproductive parameters in PCOS.

Potential benefits:

• Weight loss – especially in those living with obesity or severe insulin resistance
• Improved insulin sensitivity and lower fasting insulin - especially in those with severe insulin resistance
• Reduced appetite 

Potential drawbacks:

• Side effects: nausea, constipation, vomiting, gallbladder issues, and fatigue are commonly reported
• Nutrient deficiencies: reduced appetite can lead to low intake of protein, iron, B12, and fibre
• Loss of muscle mass: rapid weight loss may lead to a decline in lean mass if not well supported
• Cost and access: these medications are not always available on the NHS for PCOS and can be expensive privately
• Unknown long-term effects: most studies in PCOS are under 1 year, and there is no data yet on long-term safety or fertility outcomes

Things to consider

GLP-1 agonists are not a quick fix – they should be paired with dietary and lifestyle strategies to avoid potential nutritional deficiencies or any potential rebound weight gain when stopping the medication. Appetite suppression can also make it hard to eat enough protein or vegetables, which are key for ongoing health.

Also, they are not suitable for everyone. People with a history of pancreatitis, certain thyroid conditions, or gallbladder disease should avoid them. And they should never be used during pregnancy or while trying to conceive.

The research shows that GLP-1 agonists may offer real benefits to some women with PCOS – particularly those who have struggled with insulin resistance and weight for a long time – but they are not without risk. They don’t replace the foundations of hormone support: blood sugar balance, stress regulation, nutrient-dense meals, and regular movement.

If you’re considering medication, it’s important to speak with your GP or endocrinologist. If you’re interested in supporting your body’s own production of GLP-1, check out my blog here.

**This article is for educational purposes only and is not a substitute for medical advice. BANT-registered nutrition practitioners do not diagnose or treat medical conditions, nor do they prescribe or alter medication. Always consult your GP before making any changes to your medications or supplements**