Ozempic, Wegovy, Mounjaro for PCOS: 9 Key Questions Answered

Taking Ozempic for PCOS is a seductive proposition. Same with Wegovy and Mounjaro. They’re often promoted as an easy solution to weight loss and insulin resistance.

But these are new drugs with unknown long-term consequences. They only work as long as you’re taking them, so you’re either on them for life or you need another solution. If you can’t get them covered by insurance, they’re also incredibly expensive. Either way, all these treatments need to be coupled with dietary changes to get the best results.

But as so many participants from my free 30-Day PCOS Diet Challenge have shown, a PCOS diet can make these treatments unnecessary.

Yes. I’m biased. But with an open mind, I’ve researched and answered the nine most asked questions about Ozempic, Wegovy, and Mounjaro for PCOS.

1. What Is Ozempic, Wegovy, & Mounjaro?

Ozempic is one of many drugs classed as GLP-1 receptor agonists. The generic name is semaglutide.

Ozempic is a self-injected diabetes medication that you take once a week. It was first approved for use in 2017.

Wegovy is the same thing as Ozempic but was approved as a weight loss drug in 2021. The only difference is that Wegovy contains a higher dose of semaglutide.

Mounjaro is the newest drug out of these three similar treatments. Tirzepatide is the generic name of the active molecule. Approved in 2022 for type 2 diabetes, Mounjaro is in the same class as Ozempic. But it also targets an additional hormone receptor (GIP). This is supposed to make it more effective.

All these drugs are being used off-label to treat PCOS.

2. Why Take Ozempic for PCOS Symptoms (or Its Alternatives)?

Insulin resistance is a big problem for the majority of people with PCOS.

One of insulin’s many roles is to transport glucose from the blood into cells. When you have insulin resistance, your body is less responsive to insulin. Your body compensates for this problem by keeping insulin levels high all the time. Not just when it’s needed. This unhealthy state of affairs affects most overweight women with PCOS [1]. Many normal-weight PCOS women are also insulin resistant [2].

Insulin resistance is one of the underlying drivers of all PCOS symptoms [3]. When combined with a “poor diet”, insulin resistance causes weight gain and increased risks of heart disease [4]. It causes irregular menstrual cycles and makes acne and hirsutism worse.

Diet has the biggest impact on insulin resistance. That’s why participants in my free 30-Day PCOS Diet Challenge see amazing changes within a few weeks of following my PCOS meal plans. It’s not just their weight that improves. They see improvements in their cycle, reductions in acne, and less unwanted hair.

Taking Ozempic, Wegovy, or Mounjaro is another way to reverse insulin resistance. This can help restore a healthier hormone balance for women with PCOS.

Both Ozempic and Wegovy improve the control of blood glucose levels [5, 6]. This helps with weight loss which has an indirect impact on insulin resistance [7, 8].

Mounjaro shares this benefit. But it may also directly improve insulin sensitivity through a distinct mechanism beyond weight loss [9].

3. How Do They Help Insulin Sensitivity & Insulin Resistance?

Ozempic and Mounjaro counteract insulin-resistant PCOS in several ways [10]. These effects all drive weight loss.

1. They stimulate insulin secretion only after eating. This helps reduce blood sugar spikes. The post-meal increases in insulin production from Ozempic or Mounjaro are healthier than the constantly high insulin levels that result from insulin resistance.
2. Ozempic and Mounjaro can lower blood sugar levels overall. They do this by preventing the release of glucose from the liver.
3. These treatments make you feel fuller for longer. This results in you eating less which reduces demand for insulin.
4. These medicines may also decrease inflammation and help modulate fat metabolism.

The figure below shows the changes in A1C achieved by Ozempic and Mounjaro. Note that “Semalglutide 1 mg” = Ozempic, and “Semaglutide 2.4 mg = Wegovy. Tirzepatide is Mounjaro at various doses.

Figure 1. Changes in A1C levels from using Ozempic and Mounjaro compared with placebo [11].

4. Can Ozempic, Wegovy, & Mounjaro Help with Weight Loss?

One clinical trial gave Wegovy to obese, non-diabetic patients for 68 weeks. The group who received Wegovy lost 12% more weight than the control group [8, 12]. This was a difference of 28 lb (12.7 kg).

The figure below shows the proportion of patients who lost over 5, 10, and 15% during trials of Ozempic and Wegovy. Note that “Semalglutide 1 mg” = Ozempic, and “Semaglutide 2.4 mg = Wegovy.

Figure 2. The proportion of patients taking Ozempic and Wegovy who lost weight compared with placebo [11].

One of the most interesting findings from this study was that three people achieved more than 15% weight loss with a placebo. These individuals achieved comparable weight loss to those taking Wegovy. But they had no risk of adverse events. This weight loss was achieved with diet and exercise alone which seems like a much better solution.

This is why experts always recommend combining weight loss drugs with dietary interventions. Low-carb diets are helpful [13]. That’s what you’ll find in my free 3-Day Meal Plan and my free 30-Day PCOS Diet Challenge.

Mounjaro weight loss trials have also been conducted on obese, non-diabetic patients [14]. The average difference in weight loss for the lowest dose of Mounjaro compared to the control group was 12%. But patients on the highest dose of Mounjaro achieved an average weight loss difference of 18%. Other studies have further supported Mounjaro’s weight loss effects for diabetic patients [15-17].

The figure below shows the proportion of patients who lost over 5, 10, and 15% during trials of Mounjaro.

Figure 3. The proportion of patients taking Mounjaro who lost weight compared with Placebo [11].

In June 2021, the FDA approved Wegovy for weight loss. This approval is for overweight patients with a BMI > 27 kg/m2 and at least one other weight-related condition. No co-morbidities are needed for patients with a BMI > 30 kg/m2.

Mounjaro received FDA approval in May 2022. But this approval was limited to patients with type 2 diabetes.

5. Which is Better? Mounjaro vs Ozempic for PCOS

In 2021, results were published from a comparison trial of Mounjaro vs Ozempic [18]. This study was funded by Eli Lilly, the maker of Mounjaro.

They found that Mounjaro outperformed Ozempic on both weight loss and insulin sensitivity. This suggests that Mounjaro may be superior to Ozempic. But more trials are needed to confirm these findings. At the time of writing, higher doses of Ozempic/Wegovy have not been compared with Mounjaro.

6. Can These Drugs Help with PCOS Fertility?

Obese women with PCOS suffer from several reproductive disadvantages. This includes reduced egg quality [19], disrupted embryo development, and impaired receptivity of the uterus [20].

Obesity and insulin resistance are the main factors that cause this reduced fertility [21-23].

For overweight women with PCOS, reducing body weight is the best way to improve fertility and pregnancy outcomes [24]. Weight loss of 5-10% can make a profound difference [25-28].

Ozempic, Wegovy, and Mounjaro cause weight loss in overweight people. Because of this, they can indirectly improve fertility in a subset of the PCOS population.

7. Is Ozempic Better than Metformin?

Metformin is one of the most well-established insulin-sensitizing medications [29]. It’s often prescribed for PCOS patients to promote weight loss and/or address infertility.

But metformin has well-known side effects [30, 31]. Many patients are unable to tolerate metformin for this reason. It’s also known to deplete nutrients with long-term use [32-40]. The limited net benefits of metformin for PCOS are why alternatives like Inositol and Berberine are becoming more popular.

Ozempic may be another suitable option for PCOS patients. See a side-by-side comparison of Ozempic vs metformin here. The relative weight loss benefits of Ozempic vs metformin for PCOS patients are currently being investigated.

Like all insulin-sensitizing medications, it’s important to remember that Ozempic only works as long as you take it. A good PCOS diet should remain a number one priority for anyone that wants to manage this syndrome long-term.

8. What are the Risks of Ozempic, Wegovy, Mounjaro?

Ozempic, Wegovy, and Mounjaro are new drugs. They’ve passed regulatory safety assessments, but little is known about their long-term safety.

Warnings

There are some known risks stated in the prescribing information for these drugs. For example, it’s not known if Ozempic is safe to take during pregnancy or if it passes into your breast milk. The makers recommend that you don’t take it two months before you plan to get pregnant. Based on animal studies, Eli Lilly warns that Mounjaro may cause fetal harm.

Inflammation of the pancreas has been reported in clinical trials of Ozempic. Mounjaro has not been studied in patients with a history of pancreatitis for this reason.

For people with type 2 diabetes, Ozempic and Mounjaro may increase the risk of damage to the eyes (diabetic retinopathy). There are also warnings against the use of these drugs if you have acute kidney injury or gallbladder disease. Animal studies have raised concerns that medicines like Ozempic and Mounjaro may cause thyroid tumors, including cancer.

Side Effects

“Ozempic Face” is one of the most interesting side effects of Ozempic (and Mounjaro). This is where your face sags and your skin ages as a result of rapid weight loss. This may be unavoidable. Some doctors may recommend facial fillers to treat this side effect.

More than 5% of patients treated with Ozempic report adverse reactions. The most common of these include nausea, vomiting, diarrhea, abdominal pain, and constipation. Some patients also experience redness, swelling, or itchiness at the site of injection. For Mounjaro, side effects are similar and dose-dependent [41].

Because Ozempic lowers blood glucose, you also need to be mindful of hypoglycemia. This is especially important if you’re taking other blood sugar medications.

Drug Interactions

Drugs.com lists 247 drug interactions with Ozempic.

Most significantly for PCOS, this list includes:

• Insulin and oral hypoglycemics.
• Diuretics that are used to treat high blood pressure.
• Hormone-related medications like ethinyl estradiol, levonorgestrel, and norethindrone (progesterone). These are used in birth control.
• Thyroid medications like levothyroxine used for hypothyroidism.

Ozempic may also interact with many antibiotics, antipsychotics, and corticosteroids.

9. What Happens When You Stop Taking It?

Ozempic, Wegovy, and Mounjaro only work as long as you’re taking them. Any weight lost during treatment will return if treatment stops. Unless you also adopt effective diet changes. One study found that Wegovy users regained two-thirds of their prior weight loss within a year of stopping treatment [42].

This means that at best, you need an exit strategy. Or maybe you don’t need these drugs at all?

If you want good health over the long run, switching to a PCOS-friendly diet is your safest option. This is one of the biggest takeaways from past 30-Day Challenge participants. For example, Kendall took three years to lose 110 pounds using only dietary interventions. She didn’t take weight loss or insulin-sensitizing medication. As a result, she’s kept the weight off ever since and had two natural pregnancies.

The Bottom Line

Ozempic, Wegovy, and Mounjaro are new drugs that may be useful for PCOS. They help with weight loss and insulin sensitivity. This lowers the risk of diabetes and heart disease in at-risk people. For overweight and insulin-resistant patients, these medicines can enhance fertility.

But they’re not without their risks. Long-term safety research is limited. They’re expensive and they only work as long as you’re taking them. Dietary interventions can get similar results. These are guaranteed to be safe and can further enhance your quality of life long-term.

For help putting a PCOS diet into practice, join my free 30-Day PCOS Diet Challenge, or download this free 3-Day Meal Plan to get started today.

FAQ

Is Mounjaro approved for PCOS? Mounjaro is not approved for PCOS. The FDA has only approved this drug for type 2 diabetes. Ozempic is also only approved for type 2 diabetics.

How is Ozempic administered? Ozempic is injected just under the skin using a small syringe with a fine needle. It’s a simple process that you do yourself at home.

How do I store Ozempic? Syringes of Ozempic should be stored in the fridge as it needs to stay cool until its first opened. After that, it can be stored at room temperature for 56 days. It’s important not to freeze the syringe or expose it to excess heat or sunlight.

How long does it take for Ozempic to show results? Improvements in blood glucose control and weight loss may be noticed after a few weeks of starting treatment. More significant results occur after 4-12 months.

Is Ozempic covered by insurance for the treatment of PCOS? This depends on your plan. Ozempic is usually only covered by insurance if you have type 2 diabetes. A PCOS diagnosis (without diabetes) is unlikely to be covered. This can be a major obstacle to treatment. In the US, Ozempic costs more than $1000/mth.

Will insurance cover Mounjaro for PCOS? Mounjaro is not approved for PCOS or weight loss. In most circumstances, insurance companies will only cover Mounjaro for PCOS patients with type 2 diabetes. This will depend on your insurance plan and drug benefits.

Is it safe to take Ozempic while pregnant or planning to conceive? The makers of Ozempic state that the safety of this drug to unborn children is not known. They recommend stopping Ozempic for two months before trying to conceive.

Are there any specific dietary or lifestyle changes I need to make while on Ozempic? There aren’t any specific diet changes needed to take Ozempic. But you’ll get the best results if you also follow a PCOS diet.

Will I need to continue taking Ozempic indefinitely? Without diet and lifestyle changes any benefits of Ozempic will end with discontinuation.

What happens if I miss a dose of Ozempic? If you miss a dose, there are no immediate or severe consequences. But it may result in less stable blood sugar levels which can reduce the effectiveness of treatment. If you miss a dose and it’s been less than 5 days, it’s recommended that you take it as soon as possible. Otherwise, skip the missed dose, and continue with your weekly schedule.

Can Ozempic cause low blood sugar (hypoglycemia)? Ozempic can cause low blood sugar levels. This is more likely if you’re taking it with other hypoglycemic treatments. This includes natural treatments like inositol and berberine.

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