Healthy Habits - Can I use Ozempic for weight loss to manage symptoms from PCOS?

 By Dr. Ilana Ressler, Reproductive Endocrinologist, Illume Fertility

Polycystic ovary syndrome (PCOS) is a common, complex hormonal condition affecting women. It is characterized by irregular periods, elevated androgens (hormones such as testosterone) and multiple follicles (structures that contain eggs) in one or both ovaries. The condition is estimated to affect 8 to 13 percent of reproductive-age women and is closely linked to obesity. 

Women who are considering using common weight-loss medication might also be wondering if the same medication can be used to treat PCOS. The secondary effects of obesity that are associated with PCOS can be treated through a variety of methods, however no weight loss drugs have been approved to treat PCOS. Since there is no cure for PCOS, the goal is to address its symptoms so that women with the condition can live the fullest, healthiest life possible. 

Recently, evidence has shown that Ozempic (semaglutide) in higher doses promotes weight loss and can be used as a drug to treat obesity. A clinical trial is underway to assess its efficacy in obese patients with PCOS. Participants in the trial were girls ages 12 to 21 years with obesity and PCOS, divided into two groups. One group took a daily oral tablet of Ozempic for 4 months. The other group received 12 weeks of dietary intervention to lower hepatic fat and improve insulin sensitivity. The trial is expected to be completed in July 2024.

In another study, a regimen of short-term liraglutide (FDA-approved to treat weight loss under the brand name Saxenda) was associated with significant weight loss in a subset of obese patients with newly diagnosed PCOS and a higher metabolic risk profile.

Weight loss medications can have positive effects on the other symptoms of PCOS. Specifically, some studies have provided additional insights into the benefits of glucagon-like peptide 1 receptor agonists (GLP-1RA) ― drugs such as Ozempic, Saxenda, Byetta and Trulicity, which are prescribed to treat obesity ― to patients diagnosed with PCOS:

• Pregnancy rates: One study compared pregnancy rates in PCOS patients treated with two drugs, Byetta (exenatide) and metformin (a Type 2 diabetes drug classified as a biguanide). The study’s main outcome, the natural pregnancy rate following pre-treatment, was significantly higher in the exenatide group compared to the metformin group. The authors proposed weight loss to most likely be the main contributor to the subjects’ improved fertility.

• Menstrual cycles: One study compared the effects of exenatide, metformin and a combination regimen on the menstrual cycles of overweight women with PCOS. A significant improvement in the ovulation rate was demonstrated in all the groups, and weight loss was suggested as the driving factor. The conclusion appears to be that combination therapy was superior to either drug alone in improving menstrual cyclicity and ovulation rate.

• Cardiovascular disease: Many people with PCOS have insulin resistance, which is linked to cardiovascular disease. Medications like Ozempic and Mounjaro (a drug used to control high blood sugar in people with Type 2 Diabetes) work effectively to increase insulin sensitivity and production, and can be an excellent tool for those with PCOS.

In addition, these drugs can help reduce chronic inflammation and lower the risk of non-alcoholic fatty liver disease, both conditions that can be associated with PCOS. Since PCOS doesn't always present the same way in every individual, it’s important to consult with a reproductive endocrinologist to see if weight loss medications are appropriate for you.

Dr. Ilana Ressler, a Reproductive Endocrinologist with Illume Fertility, is board-certified in Obstetrics and Gynecology, and in Reproductive Endocrinology and Infertility, in Connecticut and New York.