Weight Loss Drugs and Menopause - Can They Help? | Stella
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Can Wegovy or Ozempic help during menopause?

byDr. Nick Morse

Wegovy and Ozempic are a hot topic right now. They are the two most common brand names in an important new group of weight loss medications known as ‘Glucagon-like peptide-1 agonists’ or GLP-1 medications. They make weight loss easier and could help menopause symptoms beyond weight gain. But what’s the catch? We explore the latest evidence and consider the pros and cons to help you decide if they could help you through menopause.

How do GLP-1 medications work?

GLP-1 or glucagon-like peptide-1 is a natural hormone that affects your appetite and how much food you eat. It is released when you eat food and makes you feel full and satisfied. 

GLP-1 medications make you feel full quicker, so you eat fewer calories. These medications also help by stabilizing your blood sugar levels. Balanced blood sugar levels help reduce cravings and binge eating.

How much weight can you lose on GLP-1s?

Research shows that taking Wegovy for 68 weeks – almost a year and a half – can lead to weight loss of around 16% of your body weight. In the study, participants also ate fewer calories and had behavioral therapy.

This sounds very promising, but these drugs aren’t a ‘quick fix’. In an ideal world, changing how you eat and moving more would be enough for you to lose weight. GLP-1 medications are for people who need to lose weight for health reasons but have struggled to do so through lifestyle change.

Is weight loss on Wegovy or Ozempic permanent?

GLP-1 medications only work as long as you take them. Once a healthy weight has been reached, you will likely be advised to gradually come off the medication. This is why a healthier lifestyle alongside taking GLP-1 medication can help, such as:

  • Reducing the amount of calories you eat each day
  • Increasing how active you are

Read more about how to make healthy habits that stick.

Are GLP-1 medications new?

GLP-1 medications were originally for managing type 2 diabetes. Researchers later found that the drugs were very effective for weight loss, even in people who did not have diabetes. 

The active ingredient in both Ozempic and Wegovy is semaglutide. Wegovy is the brand name approved specifically for weight loss, while Ozempic is the medication originally created to treat type 2 diabetes. 

Other medications in the same group include Mounjaro and Zepbound, which contain tirzepatide, and Saxenda, which contains liraglutide. All these medications are different GLP-1 drugs sold under different brand names.

What menopause symptoms can GLP-1 drugs improve?

Weight management

Weight loss has many benefits, but it can be particularly important during perimenopause and menopause if you are overweight or obese. 

Both men and women tend to gain weight with age, but for some people this happens faster during menopause. The exact reasons are not completely understood but it is probably due to a combination of hormonal changes and other menopause symptoms that mean keeping a healthy lifestyle is challenging. 

One direct effect of decreasing estrogen levels is that women tend to gain fat around their middle – before menopause, fat tends to gather in your thighs and buttocks. 

Increased fat affects other menopause symptoms. It can make hot flashes, sleep difficulties, joint pain, and low self-esteem worse.

Hot flashes and night sweats

It is common for day time hot flashes and night time sweats to improve after significant weight loss. Significant weight loss usually means a 5% reduction in body weight. For example, if you weighed 160lbs, this would mean losing 8lbs. 

We don’t know exactly why losing weight helps these symptoms. It may be due to reduced insulation from fat, decreased inflammation, better blood sugar control, better sleep, or even an improvement in how well the temperature-regulating areas in your brain work.

Blood sugar control

GLP-1s can improve blood sugar control, which has many health benefits during menopause. Lower insulin levels and blood glucose reduce the chance of damage to blood vessels, eyes, joints, and more. Lower insulin levels can also help reduce inflammation and the amount of glucose that turns into fat.

Heart and blood vessel health

GLP-1s have beneficial effects on the heart and the blood vessels. Studies show that GLP-1 treatment – when taken for around one year – results in less death and disability from heart disease, such as strokes and heart attacks. 

Scientists think this is related to a decrease in blood pressure, inflammation, and insulin, as well as an improvement in blood lipids.

Are weight loss drugs safe for menopause?

All medications have side effects and risks, and weight loss drugs like Wegovy are no exception. There are both short-term side effects and some long-term concerns. Keep in mind that these medications are relatively new and we do not have as much information as we would like about potential long-term harmful effects.

Common GLP-1 side effects?

The following side effects have been reported for Wegovy

  • Nausea 
  • Diarrhea
  • Vomiting
  • Constipation
  • Abdominal pain
  • Fatigue
  • Upset stomach
  • Dizziness
  • Excessive burping

Uncommon GLP-1 side effects

  • Kidney injury. GLP-1s have been associated with kidney injury in patients who didn’t previously have any kidney problems. These have been rare and, in most cases, problems have gone away when the medication is stopped  
  • Hypoglycemia. GLP-1s help lower blood sugar, but sometimes this is ‘too much of a good thing’ and leads to blood sugar levels that are unhealthy. This has happened in people with diabetes who are already on other blood sugar medicines
  • Digestive problems and nausea. Some have developed serious intestinal problems or severe nausea and vomiting. Such occurrences are uncommon, but they can be life-threatening 
  • Gallbladder disease and pancreatitis. Some studies report an increased risk of these conditions 
  • Increased heart rate. Some people who take GLP-1s seem to develop an increase in heart rate by about 5-20 beats per minute, but there is no evidence that this is harmful

Long-term risks

  • Thyroid cancer. Some animal studies show that GLP-1s can increase your risk of thyroid cancer. Anyone who is at higher risk of thyroid cancer, for example with a personal or family history, should not take GLP-1 medications 
  • Loss of muscle. GLP-1s could lead to a loss of muscle as part of overall weight loss. Menopause is also linked to muscle loss, so it is particularly important to work on your strength if you are at this life stage. Make sure you get enough exercise and protein when taking GLP-1s to help prevent muscle loss, and reduce risk of falls. Read more about the best exercise for menopause

What weight loss drugs are FDA-approved for menopausal weight loss?

No weight loss drugs are specifically approved for weight loss during menopause, but Wegovy, Saxenda, and Zepbound are all FDA-approved and suitable for adults over 18. No upper age limit has been set.

Who can take Wegovy, Sexanda, or Zepbound?

You can take Wegovy, Saxenda, or Zepbound if you have a BMI over 30, or a BMI over 27 with at least one ‘weight-related comorbidity’. This phrase refers to health problems that are related to weight and includes:

  • Type 2 diabetes
  • Hypertension
  • High cholesterol
  • Chronic kidney disease
  • Heart attack
  • Stroke

You shouldn’t take these medications if you:

  • Are at higher risk of thyroid cancer, for example, if you have a family history or a genetic condition that increases your risk
  • Are pregnant or planning to become pregnant

How can you get GLP-1 medications?

You have a few options.

  1. Ask your primary care physician, if you have one. They may be able to prescribe these medications for you. They are likely covered by your health insurance when prescribed this way. Be aware that shortages may affect how fast you can get hold of your medication.
  2. Visit a weight loss clinic in person. Shortages are less likely to affect you, but you may be out of pocket. These medications can cost as much as $1,000 or more per month.
  3. Sign up with an online clinic. This is also a quick way to access these medications, but you will likely pay top prices.

These drugs are in high demand, which is causing shortages. Some businesses are taking advantage of the situation and selling unsafe or even fake drugs. Be careful – only get medication from a trusted pharmacy in its original, unopened box.

Can you take GLP-1 drugs and HT?

At the time of writing no published research studies the effect of taking HT and GLP-1s together. 

That said, there have now been thousands of women taking both types of medications at the same time, and there have not been concerning reports of any adverse interactions.

Final word

GLP-1 medications like Wegovy, Ozempic, Zepbound, Mounjaro, and Saxenda are an exciting step forward for weight management. They are generally safe and very effective if you have struggled to lose weight through lifestyle change and need to lose a significant amount – about 5-15% of your body weight. 

These drugs are expensive and there are shortages, particularly if you are trying to get the drug covered by insurance. Watch out for scams that sound too good to be true. 

Find out more about menopause on our blog or in our symptoms library.