Women across the nation have connected online over their unexpected pregnancies, known as “Ozempic babies,” while using GLP-1 medications like Ozempic and Mounjaro, despite being on birth control or struggling with infertility. This increase in pregnancies is not a coincidence. Experts in reproductive and obesity medicine have observed this trend in their practices, attributing it to two main factors. Weight loss can help balance hormonal issues caused by obesity and metabolic disorders, thus improving fertility. However, certain GLP-1 medications can also impact the efficacy of birth control pills, raising the risk of unintended pregnancies. The effect of GLP-1s on birth control depends on the type of contraception used. Those on oral birth control pills may need additional precautions to prevent pregnancy and minimize risks associated with taking GLP-1s during pregnancy. Manufacturers advise women to stop taking weight loss medications at least two months before planned pregnancy due to insufficient research on the risks of using GLP-1 drugs while pregnant. Although these medications may enhance fertility, caution is vital as they can pose dangers during pregnancy. GLP-1s affect the gastrointestinal tract, potentially reducing the effectiveness of birth control. Delayed absorption in the GI tract can make oral contraceptives less reliable, affecting hormone levels. Studies show that tirzepatide (Mounjaro) decreases the absorption of oral contraceptives by about 20%, while other GLP-1s like semaglutide (Ozempic, Wegovy) do not impact bioavailability. The manufacturer of Mounjaro recommends barrier contraception or non-oral contraceptive methods when using the drug. GLP-1s can also cause nausea or vomiting, potentially affecting pill effectiveness. For individuals experiencing these side effects, backup contraception is recommended. GLP-1s may enhance fertility in women with PCOS, a common cause of infertility due to hormonal imbalances. Weight loss can be challenging for those with PCOS, and some clinics may require patients to reach a certain BMI before fertility treatments.
Dr. Utsavi Shah, an assistant professor of obstetrics and gynecology specializing in obesity medicine at Baylor College of Medicine in Houston, has explained that weight gain can lead to increased levels of estrogen in the body. This excess estrogen can disrupt the menstrual cycle and ovulation, making it difficult for a person to conceive. Additionally, obesity can cause insulin resistance, resulting in high levels of male sex hormones like testosterone that can negatively impact egg quality and fertility.
According to Dr. Shah, weight loss medications can be beneficial for women with conditions such as polycystic ovary syndrome (PCOS) or infertility by helping to regulate menstrual cycles and improve the chances of getting pregnant. Before starting weight loss medications, it is crucial for individuals to discuss their full health history with a healthcare provider. This should include a review of interactions with current medications and the development of a plan to minimize potential complications.
It is emphasized that the decision to begin taking weight loss medications is personal, and individuals should be empowered to make informed choices about their healthcare without judgment. However, it is recommended to only use these medications if you meet specific criteria. For instance, medications like Zepbound and WeGovy are approved for weight management in adults with obesity or overweight individuals with at least one weight-related condition, such as high blood pressure or Type 2 diabetes.
If there is a suspicion of pregnancy while taking a weight loss drug, it is advised to discontinue its use immediately and consult with an obstetrician.
