Can Ozempic affect your period?

Have you started taking Ozempic and wondering how it will affect your first period? Or maybe you're considering using it and are curious about whether it impacts your menstrual cycle altogether?

This is a super important consideration for any woman when deciding to start Ozempic. But, the good news is that there hasn't been any evidence to suggest the medication can mess with your menstrual cycle.

And, if you're thinking about starting Ozempic to help you manage PCOS along with diabetes, then the breakthrough medication might even help you manage irregular periods.

If you want to learn more about the effects of semaglutide (Ozempic and Wegovy) on your menstrual cycle, we're diving into everything to do with Ozempic and periods, hormones and side effects to help you make a decision about whether this GLP-1 medication is right for you.

Does Ozempic affect the menstrual cycle?

If you're thinking about starting Ozempic (or Wegovy, which has the same active ingredient) and wondering if it can affect your menstrual cycle, the answer is a little bit more complicated than you think.

In theory, Ozempic may affect your menstrual cycle but there haven't been any clinical trials that have shown changes to one's menstrual cycle when using Ozempic.

However, Ozempic is a type of diabetes medication called glucagon-like peptide-1 (GLP-1) receptor agonists, which work to increase the hormone glucagon.

Glucagon is a hormone that's naturally produced in the gut and after meals, it helps us to feel satisfied after eating. Glucagon also helps regulate blood sugar levels by increasing insulin and decreasing glucagon release [1].

Since Ozempic works to help people with diabetes with blood sugar control, fluctuations in your blood sugar levels can affect your menstrual cycle. And, if you didn't know, blood sugar and periods are related.

Ovulation occurs around the halfway point of your menstrual cycle, increasing progesterone levels which are related to increased insulin resistance [2]. When you reach the halfway point (a.k.a the luteal phase) of your menstrual cycle, you might notice that your body isn't interacting with insulin as it normally does, which can cause hyperglycemia and a spike in your blood sugar.

So, there could be a chance that changes in blood sugar levels when taking Ozempic would impact your menstrual cycle. However, this isn't directly caused by the medication itself but rather caused by changes in blood glucose levels in your body.

Can Ozempic cause irregular periods?

Since Ozempic is a relatively new drug, there hasn't been enormous research into the drug interactions and effects on the menstrual cycle, irregular periods and missed periods.

Based on the current research from clinical trials, there hasn't been evidence to suggest that Ozempic can affect your menstrual cycle and that includes irregular periods.

However, weight loss and weight gain can impact your menstrual cycle [3]. For women who are obese or overweight and also have irregular periods or heavy bleeding, weight loss can have a positive effect on periods, causing them to become regular and lighter too.

On the other hand, losing a large amount of weight quickly can also have side effects on your periods.

Excessive weight loss can cause your periods to stop altogether, and too much calorie restriction can stop the production of hormones necessary for ovulation [4]. These indirect effects of GLP-1 medications (like Ozempic and Wegovy) can therefore impact your menstrual cycle.

If you are considering taking a GLP-1 medication for weight loss, you still want to ensure you're losing weight in a sustainable and healthy way. That's why Juniper's Weight Reset Programme is a specialist weight management program that takes a holistic approach to weight loss using a combination of weight loss medication and behavioural strategies. Juniper previously used Ozempic and now uses Wegovy.

With breakthrough medication, dietitian-led health coaching and lifestyle changes, we help you not only lose weight but keep it off too.

Through weight loss medication, Juniper's Weight Reset Programme gives your body a biological reset, targeting the areas of the brain that regulate appetite and lower your body's set point to help you kick your weight loss goals.

And, to make sure you're losing weight sustainably, our health coaches give you helpful and actionable advice to change your habits surrounding food and exercise and connect you with a supportive community of women on the weight loss journey with you.

Can Ozempic stop your period?

As we've already mentioned, there has been no evidence of Ozempic stopping periods. In fact, Ozempic can actually have positive effects on the menstrual cycle among women who have polycystic ovary syndrome (PCOS).

During each menstrual cycle, the ovaries release an egg into the uterus, but women who have PCOS either struggle to ovulate or ovulate infrequently. This means menstrual bleeding is either irregular or absent altogether, which makes it difficult to get pregnant [5].

Most women with PCOS also have insulin resistance (otherwise known as insulin sensitivity, where your body builds a tolerance to insulin), regardless of whether they are overweight or obese. Treatment for insulin sensitivity can help women with PCOS reduce the likelihood of developing diabetes and can also help with weight loss [6].

While other medications have commonly been used as a treatment for PCOS, including Metformin or oral contraceptives (a.k.a the pill), since Ozempic entered the picture, studies have suggested that it can positively impact PCOS.

One study showed that GLP-1 receptor agonists were superior to Metformin for women with PCOS in improving insulin resistance and reducing body mass index (BMI), body weight and abdominal circumference.

When comparing Ozempic and Metformin, there were no differences between the 2 medications on menstrual frequency, meaning Ozempic didn't stop or cause irregular periods [7].

Another study comparing GLP-1 receptor agonists and Metformin showed that Ozempic was a helpful medication used to improve blood sugar control and insulin and had positive impacts on sex hormones and period regularity [8].

Does Ozempic affect hormones?

The active ingredient in Ozempic and Wegovy, semaglutide, does affect your hormones, mainly by mimicking the natural hormone produced by your gut called GLP-1.

GLP-1 is created by your digestive system in response to eating meals, regulating the feeling of satisfaction and fullness after your meals and slowing down your stomach emptying into the rest of the digestive system.

Plus, GLP-1 also regulates the production of insulin in response to eating, which in turn, creates low blood sugar levels and reduces your appetite.

For women with PCOS who produce too much insulin, this can also cause too much androgen production in the ovaries and affect other female reproductive hormones [9].

But, as we've mentioned, Ozempic can affect hormones in positive ways, with studies showing improvements in blood sugar and insulin which also have a beneficial impact on female reproductive hormones for women with PCOS.

What are the most common side effects of Ozempic?

Like all medications, Ozempic can cause side effects or cause an allergic reaction. But, the good news is that these side effects are generally mild and temporary as your body adjusts to the treatment, which generally affects 10% of people taking Ozempic [10].

The most common side effects of Ozempic include [1]:

• Loss of appetite
• Mild nausea
• Vomiting
• Dizziness
• Fatigue
• Headache
• Abdominal pain or stomach cramps
• Acid reflux/heartburn
• Diarrhoea, constipation or upset stomach
• Burping and flatulence

There are some other possible side effects that are rare but can affect a small group of patients — usually fewer than 1 in 100. More serious side effects of Ozempic include [11]:

• Pancreatitis: Acute pancreatitis is a condition where the pancreas becomes inflamed over a short period of time. In clinical trials, only 0.3% of patients developed pancreatitis while taking Ozempic. If you develop a fever, feel pain in the centre of your stomach and experience vomiting, it's important to seek medical attention immediately.
• Retinopathy: Retinopathy is the disease of the retina in the eye that can lead to vision changes, including blurred vision, patchy vision, eye pain or sudden vision loss.
• Hypoglycemia: When taking Ozempic, the risk of low blood sugar levels can increase so watch out for dizziness, lightheadedness, mood changes, swearing and slurred speech.
• Kidney problems: Among people with kidney problems, diarrhoea, nausea and vomiting can cause dehydration, which can further impact kidney-related issues. Drinking plenty of water to reduce the chance of dehydration is super important when taking Ozempic.

Another serious side effect to be cautious of when deciding whether to take Ozempic is thyroid cancer. Currently, it is unknown if Ozempic causes thyroid tumours or a form of thyroid cancer called medullary thyroid carcinoma (MTC) in people.

But, in animal studies, Ozempic did cause thyroid tumours and while the relevance for humans is low, it can't be ruled out completely.

It is advised if you have a personal or family history of thyroid cancer or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) to avoid taking Ozempic [11].

Ultimately, clinical trials of Ozempic have shown no evidence of impacting periods or menstrual bleeding. While the research into Ozempic and the menstrual cycle is limited, initial research is showing the positive effects of Ozempic for women with an irregular menstrual cycle as a result of PCOS.

Please chat with your doctor if you'd like more information.