Are GLP-1s affecting your birth control? What to know
This baby boom isn't a coincidence. Reproductive and obesity medicine experts tell USA TODAY that they're also noticing the trend in their offices, and it boils down to two main reasons.
Weight loss can help correct hormonal imbalances caused by obesity and metabolic disorders, thus boosting fertility. But certain GLP-1 medications can also reduce the efficacy of birth control pills, thus increasing the risk of an unintended pregnancy.
So are GLP-1s impacting your birth control? It depends on which type of contraception you use.
People taking oral birth control pills may need to take extra precautions to prevent pregnancy, both to reduce the risk of unintended pregnancies, but also the risks associated with taking GLP-1s while pregnant. Drug manufacturers recommend women stop taking weight loss drugs at least two months before a planned pregnancy, as not enough research has been done to fully assess the risks of taking GLP-1 medications while pregnant, according to Dr. Hayley Miller, Medical Director of Nurx Weight Management.
'It's true that, from a scientific perspective, these medications may make it easier for people to get pregnant,' Dr. Allison Rodgers, an OB-GYN and reproductive endocrinologist at Fertility Centers of Illinois, previously told USA TODAY. 'But people need to be careful because there could be dangerous consequences if taken while pregnant, given the drugs can linger in your system.'
GLP-1s impact the GI tract, reduce birth control efficacy
GLP-1s induce weight loss by slowing down the gastrointestinal (GI) tract, also known as the digestive tract, according to Miller.
With oral contraceptives, the pill should be absorbed at approximately the same time every day to maintain consistent hormone levels and maximize their effectiveness. If the GI tract is slowed down, it makes that absorption 'a lot less predictable,' which can disrupt the efficacy of birth control, Miller says.
A recent study evaluating gastric emptying with tirzepatide (Mounjaro) and oral contraceptives found that a single 5mg dose of tirzepatide was associated with an approximate 20% decrease in the amount of the oral contraceptive absorbed into the bloodstream. Semaglutide (Ozempic, Wegovy), liraglutide (Victoza) and dulaglutide (Trulicity) did not appear to affect the bioavailability of oral contraceptives.
The Mounjaro manufacturer recommends using barrier contraception, such as condoms, for four weeks after starting the drug or a dosage increase, or to switch to a non-oral contraception, such as an IUD or Nexplanon implant.
Additionally, GLP-1s can also induce nausea or vomiting. If that happens, Miller says it 'doesn't matter whether you see the pill' in your vomit – you won't truly know if it was digested, so she recommends using backup protection if experiencing these side effects.
GLP-1s may boost fertility for women with PCOS
Polycystic ovarian syndrome (PCOS), an endocrine condition in which a woman's ovaries and/or adrenal glands overproduce male sex hormones called androgens, affects 8% to 18% of reproductive-aged women and is a leading cause of infertility in women. Hormonal imbalances associated with PCOS make it difficult to lose weight, yet some clinics won't perform egg retrievals on patients unless they're below a certain BMI.
Fat cells release estrogen, so the more a person gains, the more estrogen they'll have, Shah said. Excess estrogen can prevent regular menstruation and ovulation, which can make it hard to get pregnant.
Obesity causes insulin resistance as well, which can lead to high levels of male sex hormones like testosterone that don't support pregnancy and affect egg quality, Shah said.
'These weight loss medications are game changers for women with PCOS or infertility,' Dr. Utsavi Shah, assistant professor of obstetrics and gynecology specializing in obesity medicine at Baylor College of Medicine in Houston, previously told USA TODAY. 'It's their effect on weight loss that's helping regulate their menstrual cycles, thereby increasing their chances of getting pregnant.'
Questions to ask your doctor before starting weight loss medications
For patients looking to start taking GLP-1s, Miller says it's imperative to discuss their full health history with a trusted medical provider. This includes reviewing interactions with current medications, like birth control, and creating a game plan to reduce potential complications.
The decision to start taking a GLP-1 is a personal one.
'It's important to empower people to make these kinds of choices for themselves,' Miller says. 'There shouldn't be judgment in people's decisions for healthcare.'
However, experts recommend only taking weight loss medications if you meet the criteria for their use. Zepbound and WeGovy, for example, are approved for weight management in adults who have obesity or are overweight with at least one weight-related condition, such as high blood pressure or Type 2 diabetes.
And if you suspect you're pregnant while taking a weight loss drug, stop it immediately, Rodgers said, then follow up with your obstetrician.
Contributing: Katie Camero
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