GLP-1 Agonists in Women’s Health: Benefits, Risks & Hormonal Insights

💬 Ask Aya: “What do you think about Ozempic?”
We’re asked this at least once a week—and for good reason. Medications like Ozempic, Wegovy, and Mounjaro are everywhere, marketed as breakthroughs for weight loss and metabolic health. But what’s the full story with GLP-1 agonists in women’s health—especially when it comes to hormones, fertility, and long-term vitality?

Mechanisms of GLP-1 Agonists in Women’s Health

GLP-1 (glucagon-like peptide-1) is an incretin hormone secreted by intestinal L-cells in response to nutrient intake. It plays several roles:

• Pancreatic effects: stimulates glucose-dependent insulin secretion, suppresses glucagon release, and improves β-cell function.

• Central nervous system: acts on hypothalamic satiety centers, reducing appetite and hedonic eating.

• Gastrointestinal: delays gastric emptying, prolonging satiety but sometimes impairing motility.

• Cardiovascular: promotes vasodilation, reduces inflammation, and lowers cardiovascular risk markers.

By mimicking GLP-1, medications like semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro, also a GIP/GLP-1 dual agonist) leverage these pathways for weight reduction, improved glycemic control, and metabolic protection.

For women, these effects intersect with unique hormonal landscapes—PCOS, perimenopause, and postmenopausal bone and cardiovascular health.

Benefits of GLP-1 Agonists in Women’s Health

• Polycystic Ovary Syndrome (PCOS): GLP-1 therapy reduces insulin resistance and circulating androgens, sometimes restoring ovulation and menstrual regularity. In metformin-intolerant PCOS patients, liraglutide improved weight, insulin sensitivity, and reproductive function (Jensterle et al., 2019).

• Fertility outcomes: Improved ovulation rates in PCOS, weight loss leading to enhanced IVF outcomes, and possible improvements in luteal phase sufficiency.

• Menopause & cardiometabolic health: Postmenopausal women using GLP-1s see improvements in visceral adiposity, lipids, and cardiovascular markers—important since CVD is the leading cause of death post-menopause.

• Weight management: Average loss of 10–15% of body weight (Wilding et al., 2021), sometimes more with dual agonists like tirzepatide.

• Glucose & insulin control: Particularly beneficial for women with prediabetes, type 2 diabetes, or metabolic syndrome.

Risks of GLP-1 Agonists in Women’s Health

1. Digestive & Microbiome Concerns

• Slowed gastric emptying can predispose to reflux, bloating, and constipation.

• Small bowel stasis increases risk of SIBO and microbial dysbiosis.

• Reduced appetite may also reduce dietary fiber intake, further shifting microbiome balance.

2. Lean Mass Loss

• Up to 40% of weight loss on GLP-1s may be lean tissue, not fat. This compromises basal metabolic rate, mitochondrial health, and long-term weight maintenance.

• Women are already more prone to muscle loss (sarcpenia) post-40, making strength training and protein sufficiency critical.

3. Hormonal & Fertility Effects

• Rapid weight loss can disrupt the hypothalamic–pituitary–ovarian (HPO) axis, sometimes causing amenorrhea.

• Nutrient deficiencies (iron, zinc, B vitamins) from reduced food intake can impair fertility and pregnancy outcomes.

• Conversely, in PCOS, GLP-1s may restore ovulatory cycles—so contraception should be discussed in women not seeking pregnancy.

4. Bone Density & Menopausal Risks

• Weight loss itself (independent of drug) reduces mechanical loading on bone, accelerating bone loss.

• Emerging studies show declines in hip and spine bone mineral density, raising fracture risk in postmenopausal women.

5. Long-Term Unknowns

• Limited longitudinal data beyond 3–5 years.

• Unclear impacts on reproductive health, cognition, and sustained weight outcomes if discontinued.

Naturopathic Strategies for GLP-1 Agonists in Women’s Health

At Aya Naturopathic, we treat these medications as bridges—not final destinations. Our role is to minimize risks, sustain benefits, and support long-term health.

• Muscle preservation: Structured resistance training, creatine monohydrate, and adequate protein (1.2–1.6 g/kg/day).

• Nutrient density: Prioritize micronutrient-rich foods and supplementation of vulnerable nutrients (iron, zinc, B vitamins, magnesium).

• Gut health monitoring: Periodic stool testing, probiotics, and targeted fiber to mitigate dysbiosis risk.

• Hormone & fertility planning: Monitoring cycles, optimizing nutrient stores pre-conception, and tapering off medication if pregnancy is desired.

• Bone support: Resistance exercise, vitamin D, K2, magnesium, and tracking bone density in perimenopausal/postmenopausal patients.

• Psychological care: Many patients report body-image shifts and appetite dysregulation post-therapy; mindful eating and stress support are integral.

The Bottom Line on these Medications for Women’s Health

GLP-1 medications are powerful tools—neither miracle nor menace. They can support weight loss, metabolic health, and fertility in women with PCOS or obesity, but they also carry risks of muscle loss, gut disruption, hormonal imbalances, and bone density decline.

The best outcomes occur when these drugs are integrated into a holistic plan that includes exercise, nutrient optimization, and hormone-aware care.

✨ Considering GLP-1 therapy—or curious about natural alternatives? Book a free discovery call today to explore the safest, most effective path for your body and your goals.

References

• Cleveland Clinic. (2024). Weight loss drugs and muscle loss: What we know so far.

• Diabetes UK. (2025). Study outlines impact of GLP-1 medications on women’s health.

• Jensterle, M., et al. (2019). Front Endocrinology, 10, 629.

• News-Medical. (2025). Unexpected effects of GLP-1 medications on women’s health.

• The Guardian. (2024). Do diabetes jabs boost the chances of conception?

• Wilding, J. P. H., et al. (2021). NEJM, 384(11), 989–1002.