Weight Loss Drugs and Menopause - Can They Help? | Stella
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Can Wegovy or Ozempic help during menopause?

byDr Ria Gotbi

Weight loss drugs are a hot topic right now. Wegovy and Ozempic are the two most common brand names in an important group of medications known as ‘glucagon-like peptide-1 agonists’ or GLP-1 medications. They make weight loss easier and could help menopause symptoms beyond weight gain. But what’s the catch? We explore the latest evidence and consider the pros and cons to help you decide if they could help you through menopause.

How do GLP-1 medications work?

GLP-1 medications are synthetic versions of glucagon-like peptide-1, a natural hormone that affects your appetite and how much food you eat. It is released from your gut when you eat food and makes you feel fuller for longer and regulates blood sugar levels. Stable blood sugar levels help reduce cravings and binge eating.

How much weight can you lose on GLP-1s?

Clinical trials indicate that when used alongside diet, physical activity, and behavioural support, Wegovy users can achieve up to a 15% reduction in body weight after one year.

This sounds very promising, but these drugs aren’t a ‘quick fix’. In an ideal world, changing how you eat and moving more would be enough for you to lose weight. GLP-1 medications are for people who need to lose weight for health reasons but have struggled to do so through lifestyle changes.

Is weight loss on Wegovy permanent?

GLP-1 medications only work as long as you take them. This is why GLP-1 medications are prescribed as one part of a three-part weight management programme, which also includes a diet and exercise plan. Any medical conditions that impact weight must be treated at the same time. This ensures that the weight you lose during the programme is sustained if you come off the medication.

The duration of treatment with GLP-1 medications depends on several things, including your response to the treatment, personal preference or if they are being used for the long-term management of another diagnosis such as type 2 diabetes. Your doctor will create an individual treatment plan with you.

You will be prescribed these medications for a maximum of two years if received through the NHS as part of a weight loss management programme.

Are GLP-1 medications new?

GLP-1 medications have been used to manage type 2 diabetes for over a decade. Researchers later found that the drugs were very effective for weight loss, even in people who did not have diabetes. 

The active ingredient in both Ozempic and Wegovy is semaglutide. Wegovy is the brand name approved specifically for weight loss, while Ozempic is the medication originally licensed to treat type 2 diabetes. Apart from how they are licensed to be used, both medications contain the exact same compound. The main difference is that Wegovy is available in higher strengths than Ozempic.

Other medications in the same group include Mounjaro, which contains tirzepatide, and Saxenda, which contains liraglutide. All these medications are different GLP-1 drugs sold under different brand names.

What menopause symptoms can GLP-1 drugs improve?

While HRT is the most effective treatment for menopause symptoms including hot flushes, poor sleep and mood changes, GLP-1 drugs can improve the health of some people at this stage of life.

Stella has partnered with Habitual so you can explore weight loss medication as part of your menopause treatment. Take their online assessment to find out if weight loss medication could help you.

Weight management

Weight loss has many benefits, but it can be particularly important during perimenopause and menopause if you are overweight or obese. 

We all tend to gain weight with age, but for some people this happens faster during menopause. The exact reasons are not completely understood but it is probably due to a combination of hormonal changes and other menopause symptoms that mean keeping a healthy lifestyle is challenging. 

One direct effect of decreasing oestrogen levels is that women tend to gain fat around their middle. 

Increased fat can affect other menopause symptoms. It can make hot flushes, sleep difficulties, joint pain and low self-esteem worse. 

Hot flushes and night sweats

It is common for daytime hot flushes and night-time sweats to improve after significant weight loss. Significant weight loss usually means at least a 5% reduction in body weight. For example, if you weighed 90kg, this would mean losing 4.5kg. 

We don’t know exactly why losing weight helps these symptoms. It may be due to reduced insulation from fat, decreased inflammation, better blood sugar control, better sleep or even an improvement in how well the temperature-regulating areas in your brain work. 

Blood sugar control

GLP-1s can improve blood sugar control, which has many health benefits during menopause. More stable blood sugar levels may help with symptoms like fatigue, hot flushes and mood swings. 

Heart and blood vessel health

GLP-1s have beneficial effects on the heart and the blood vessels. Studies show that GLP-1 treatment – when taken for around one year – results in less death and disability from heart disease, such as strokes and heart attacks. 

Scientists think this is related to a decrease in blood pressure and inflammation, as well as an improvement in blood lipids. 

Read more about heart health and menopause.

Are weight loss drugs safe for menopause?

All medications have side effects and risks, and weight loss drugs like Wegovy are no exception. There are both short-term side effects and some long-term concerns. 

While semaglutide has been used to treat diabetes for about a decade, these medications are still relatively new as a weight loss treatment and we do not have much information yet available about potential long-term effects.

Common GLP-1 side effects

The following common side effects have been reported for Wegovy

  • Nausea and/or heartburn 
  • Diarrhea
  • Vomiting
  • Constipation
  • Fatigue
  • Dizziness
  • Injection site reactions

These side effects may flare up when your dose is increased –  symptoms usually calm down again within a few days or weeks. Everyone is different, so it is up to you to decide whether the side effects you experience are manageable. You should always discuss any side effects with your doctor.

Possible serious GLP-1 side effects 

  • Gallbladder problems. Wegovy may cause gallbladder problems such as gallstones. Let your doctor know immediately if you develop upper stomach pain, fever or pale-coloured stools
  • Pancreatitis. Stop using the medication and let your doctor know if you develop persistent abdominal pain – this can go from your stomach to your back – with or without vomiting
  • Increased heart rate. Some people who take GLP-1s seem to develop an increase in their resting heart rate by about 5-20 beats per minute. You should tell your doctor if you feel your heart pounding or racing and it lasts for a few minutes. There is no evidence that this is harmful but it should be checked out
  • Low blood sugar, also known as hypoglycemia, in patients with type 2 diabetes. This is especially common in those who take insulin or other medications for type 2 diabetes called sulfonylureas. This is a common but potentially serious side effect. Talk to your doctor about how to recognise and treat low blood sugar levels.
  • Severe allergic reactions. Symptoms of a serious allergic reaction include lip, tongue, throat or face swelling, trouble breathing or swallowing, severe rash or itching, or very rapid heartbeat, fainting or feeling dizzy. Stop using the medication and seek urgent medical attention – call 999 – if you experience any of these symptoms. 
  • Depression or thoughts of suicide. Let your doctor know if you have any new, worsening or worrying changes to your mood.  
  • Thyroid cancer. Some animal studies show that GLP-1s can increase your risk of thyroid cancer, but this has not been seen in human or primate studies. Anyone who is at higher risk of thyroid cancer, for example those with a personal or family history, should not take GLP-1 medications
  • Loss of muscle. GLP-1s could lead to a loss of muscle as part of overall weight loss. Menopause is also linked to muscle loss, so it is particularly important to work on your strength if you are at this life stage. Make sure you get enough exercise and protein when taking GLP-1s to help prevent muscle loss and reduce risk of falls. Read more about the best exercise for menopause

Read the full patient information leaflet before starting Wegovy treatment.

 What weight loss drugs are licensed for menopausal weight loss in the UK?

No weight loss drugs have been specifically created for weight loss during menopause, but Wegovy is licensed for weight loss in the UK for overweight and obese adults over 18. 

Who can take Wegovy?

You can take Wegovy if you have a BMI over 35, or a BMI of over 30 with at least one weight-related condition. These include:

  • Hypertension or high blood pressure
  • High cholesterol
  • Osteoarthritis
  • Obstructive sleep apnoea
  • Asthma/COPD
  • Non-alcoholic fatty liver disease
  • Polycystic ovarian syndrome

Some people may be eligible with a slightly lower BMI, for example those from certain ethnicities including those of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin.

You shouldn’t take these medications if you:

  • Are at higher risk of thyroid cancer, for example, if you have a family history or a genetic condition that increases your risk
  • Are pregnant or planning to become pregnant, or if you are breastfeeding.

How can you get GLP-1 medications?

You have a few options.

  1. Ask your doctor. Your doctor will carry out an assessment and refer you to an NHS specialist weight management service if appropriate. Bear in mind that this process may take a few months, as there are a limited number of spaces available
  2. Visit a private weight loss clinic in person. Like many private medical services in the UK, a consultation will likely cost a few hundred pounds, plus the cost of the medication itself, which is roughly £200-300 per month. This should also include specialist weight management support
  3. Sign up with a private online clinic. Weight loss medication from an online pharmacy may be more affordable than going to an in-person clinic. You will need to fill out an online form and, in some cases, have a call with a prescriber. Online clinics, such as Habitual, also offer behavioural support and coaching as per government guidelines. Check that the pharmacy is GPhC-registered and that the prescribers are licensed by CQC or GPhC before you buy drugs online

Can you take GLP-1 drugs and HRT?

At the time of writing there is no published research that studies the effect of taking HRT and GLP-1 medications together. 

That said, there have now been thousands of women taking both types of medications at the same time and there have not been concerning reports of any adverse interactions.

Final word

GLP-1 medications like Wegovy are an exciting step forward for weight management. They are generally safe and very effective if you have struggled to lose weight through lifestyle change and need to lose a significant amount – about 5-15% of your body weight. 

Find out more about menopause on our blog or in our symptoms library