What we know (and don’t know) about GLP-1s and women’s health

This is the third in a series of articles exploring the intersection of GLP-1s and digital health. 

Maybe it’s because of the content I consume and company I keep, but I’ve started to see some media pieces about GLP-1s and women’s health. (I’m sure my search history from researching this piece has contributed.) So today I’m going to dig into the questions that have been rolling around my brain:

• What are the specific women’s health use cases for GLP-1s beyond obesity treatment?
• What is the evidence to support these uses? 
• Are there unexpected benefits of GLP-1s for women’s health?
• Are there any negative side effects for women taking GLP-1s? 
• What are the unknowns? 

As a note, I am not going to dig into the efficacy of GLP-1s on weight loss and diabetes management, because these use cases have already been widely proven for both men and women. 

Let’s go. 

What are the specific women’s health use cases for GLP-1s beyond obesity treatment?

Polycystic Ovary Syndrome (PCOS) is caused by a hormonal imbalance in the ovaries when ovarian cysts lead to the production of higher-than-normal amounts of androgens. This can lead to irregular periods and female infertility. There are also a variety of other accompanying symptoms that may appear, such as excessive facial hair, acne, obesity, and insulin resistance. Notably, PCOS can increase the risk of developing other health problems later in life, including type 2 diabetes and cardiovascular disease. So, as GLP-1s are known to help with weight loss and metabolism improvement, could they improve PCOS symptoms? 

I came across a publication from May 2025 by Lin et al.,  Efficacy and safety of GLP-1 receptor agonists on weight management and metabolic parameters in PCOS women: a meta-analysis of randomized controlled trials. The meta-analysis included 13 studies. The authors found that women on GLP‑1 drugs lost more weight and had a bigger drop in BMI compared to those on metformin (the standard first line treatment) or a placebo. These medications also reduced fasting insulin levels and improved insulin resistance — important because insulin resistance is common in PCOS. There were mixed results on improvements in hormonal balance across the studies, indicating that there needs to be more research conducted to understand these outcomes. 

So what’s the TL;DR? GLP-1s don’t reduce the ovarian cysts that cause PCOS in the first place, but could help with the downstream health effects like obesity and insulin resistance from the disease. However, GLP-1s aren’t risk free, common side effects noted in the studies from the GLP-1s included nausea, vomiting, and dizziness, and should be discussed with patients prior to starting treatment.

Are there unexpected women’s health benefits from taking GLP-1s?

There’s emerging evidence that using GLP-1 medications up to two years before pregnancy may reduce the risk of cesarean delivery and gestational diabetes. These findings come from retrospective studies using electronic health records data, not randomized controlled trials — the gold standard for clinical research — so they should be interpreted with caution.

From a biological perspective, the connection makes sense: achieving a healthy BMI is strongly linked to better pregnancy outcomes. One article referred to an “Ozempic baby boom,” noting that some individuals who previously struggled with infertility while living with obesity were able to conceive after losing weight. But rather than pointing to something uniquely “fertility-boosting” about GLP-1s, this likely reinforces a well-established principle: reaching a healthier weight can significantly improve preconception health.

It’s also important to note that GLP-1 medications are not recommended during pregnancy, as is the case with many prescription drugs. What remains unclear—and deserves more research—is how long someone should discontinue GLP-1 treatment before trying to conceive.

Are there any women’s health specific risks with GLP-1s? 

I was particularly curious about any increased risk related to cancer. Let’s all thank Piccoli, et al. for their 2021 article, Do GLP-1 Receptor Agonists Increase the Risk of Breast Cancer? A Systematic Review and Meta-analysis. They reviewed 52 trials (!) across thousands of patients and found that treatment with GLP-1s for obesity and diabetes does not increase the risk of breast tumors. 

The jury is still out when it comes to understanding the relationship between GLP-1s and thyroid cancer. There may be an increased risk for developing thyroid cancer when women are on GLP-1s for one to three years, according to a study by Bezin, et al. However, this study led to multiple public comments, including one questioning the methods of the study and suggesting that the definitions lead to outsized risk estimations. Researchers from the Mayo Clinic also spoke out about the inconclusive evidence of increased risk of thyroid cancer when on GLP-1s. I think this all points to the need for more research.  

There appears to be a risk/benefit calculation to be made when it comes to prescribing GLP-1s to women that are postmenopausal. On one hand, women can gain 1.5 pounds per year in their 40s and 50s as they go through perimenopause. Obesity increases cancer risk for a variety of cancers, including breast and ovarian, so it makes sense that losing that weight could reduce cancer risk. On the other hand, women are already at risk of muscle mass reduction and osteoporosis as they age, and rapid weight loss could accelerate these effects. It’s important for providers to discuss lifestyle changes like adding strength training into daily routines alongside GLP-1s prescription to mitigate these risks. 

After reviewing the available literature on PubMed and beyond, it’s clear that we still have a limited understanding of how GLP-1 medications specifically impact women’s health. While it’s well-established that maintaining a healthy weight, eating a balanced diet, and engaging in regular exercise—especially strength training—can reduce the risk of chronic diseases like heart disease, diabetes, and certain cancers, the benefits currently attributed to GLP-1s in women often appear to mirror the downstream effects of those same healthy lifestyle behaviors. The key difference is that these outcomes are being initiated pharmacologically rather than behaviorally.

There’s still much to learn about how GLP-1s affect women across different stages of life, from preconception and pregnancy to postpartum and perimenopause. I’m eager to see more targeted research in the future that deepens our understanding and helps guide more nuanced, personalized care for women.