Wegovy injection pens organized in Waterbury, Vermont, US, on Monday, April 28, 2025.
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For properly over a decade, Grace Hamilton, 27, skilled hair loss, heavy durations, rare menstrual cycles, psychological well being points and problem shedding pounds with out realizing why. It wasn’t till 2021 when she was identified with polycystic ovary syndrome, or PCOS, a hormonal dysfunction frequent amongst ladies of reproductive age.
After she noticed restricted enhancements from contraception, weight loss program and train, Hamilton joined a trial in 2024 analyzing a GLP-1 drug in PCOS sufferers. By October, she acquired her first weekly dose of semaglutide, the lively ingredient in Novo Nordisk‘s weight problems injection Wegovy and diabetes shot Ozempic.
She mentioned some outcomes had been nearly rapid: after months with out a cycle, her interval resumed inside two weeks of beginning the drug. After 10 months on the therapy, Hamilton misplaced 50 kilos, noticed hair regrowth and reported important enhancements in despair and nervousness
“I am so glad that I caught with it as a result of it was simply clear as day that it was the lacking hyperlink for me,” mentioned Hamilton, who works at a nonprofit in Arvada, Colorado, including that she maintained weight loss program and train whereas on the drug.
She is only one of a number of ladies who’ve reported enhancements in signs of PCOS after utilizing GLP-1s, a rising class of weight problems and diabetes remedies which have drawn large affected person demand and investor buzz over the previous couple of years. Treating PCOS is amongst a number of new however unapproved potential makes use of of the blockbuster medicine past selling weight reduction and regulating blood sugar.
Grace Hamilton, a affected person with PCOS speaking GLP-1s in Galway, Eire.
Courtesy: Addison Peacock
PCOS, which is incessantly underdiagnosed, impacts an estimated 5 million to six million ladies of reproductive age within the U.S., in keeping with some estimates.
The situation is usually characterised by larger ranges of testosterone and different hormones normally related to males known as androgens, which might results in signs similar to irregular and painful durations, extra hair progress and zits. PCOS is the most typical reason behind infertility.
The situation is strongly linked to metabolic points, as an estimated 35% to 80% of sufferers expertise insulin resistance. Which means the pancreas pumps out extra insulin to maintain blood sugar in verify, and excessive insulin ranges can promote weight achieve and disrupt hormone stability. A big share of ladies with PCOS have weight problems or Sort 2 diabetes.
But there is no normal PCOS therapy. Present choices like contraception, way of life adjustments and the diabetes drug Metformin might solely assist with sure signs, which may differ relying on the affected person.
However some well being specialists see promise in GLP-1s, notably given their impact on bettering weight reduction and insulin sensitivity.
“The unmet want is huge,” mentioned Dr. Melanie Cree, a pediatric endocrinologist at Kids’s Hospital Colorado. “Major therapies used for PCOS signs have not modified in practically 50 years.”
Cree has been finding out the impact of GLP-1s in adolescents with PCOS for greater than 10 years. She beforehand studied the oral type of semaglutide and has an ongoing scientific trial on the injectable model, which is what Hamilton participated in for 10 months.
However her research are nonetheless small compared to drugmakers’ earlier scientific trials on GLP-1s with 1000’s of sufferers. Not the entire ladies who’ve thus far accomplished Cree’s ongoing examine misplaced important weight, demonstrating that not everybody might reply to GLP-1s.
Novo Nordisk and rival Eli Lilly have been finding out their GLP-1s as potential remedies for different power circumstances like fatty liver illness, however not PCOS. Cree mentioned that is as a result of the Meals and Drug Administration has not established particular “endpoints” or objectives medicine should meet in scientific trials to display how efficient they’re for PCOS.
In an announcement, a Novo Nordisk spokesperson mentioned the corporate welcomes “unbiased analysis investigating the security, efficacy and scientific utility of our merchandise, together with semaglutide.” Eli Lilly didn’t instantly reply to a request for remark.
Conducting longer and bigger trials to raised perceive the impact of GLP-1s on PCOS signs is essential, mentioned Sasha Ottey, govt director of the advocacy group PCOS Problem. It’s nonetheless unclear if GLP-1s can assist handle or resolve all PCOS signs, or whether or not the impact differs relying on a affected person’s age or the particular drug, Ottey mentioned.
She added that sure sufferers might not shed some pounds on GLP-1s, and others might not must shed kilos.
In the meantime, insurance coverage protection for GLP-1s is a barrier for some PCOS sufferers, who are sometimes eligible for accredited makes use of of the medicine. Most plans cowl GLP-1s for diabetes, however not for weight problems or unapproved makes use of. The medicine can value roughly $1,000 monthly earlier than insurance coverage. Nonetheless, Eli Lilly and Novo Nordisk provide important reductions on their medicine to some sufferers who pay for it out-of-pocket.
Why GLP-1s might handle PCOS signs
Extra analysis is required to totally perceive why GLP-1s might assist some PCOS sufferers, however Cree mentioned their impact on signs seems to be largely oblique.
She mentioned a key discovering in a number of earlier research motivated her to start out finding out GLP-1s: In adults with PCOS, dropping as little as 5% of physique weight can enhance insulin sensitivity.
That makes the physique reply higher to insulin, so it does not want to provide as a lot of it to handle blood sugar. That lowers insulin ranges, which Cree and a few researchers consider causes the ovaries to provide much less testosterone and, because of this, can assist scale back signs similar to irregular durations, zits and extra hair progress.
“One of many questions was, what different strategies do we now have to enhance insulin sensitivity?” Cree mentioned. She famous that different advisable remedies for PCOS signs, similar to meals adjustments, rising train and the diabetes drug Metformin, are primarily based on that objective.
GLP-1s similar to semaglutide enhance insulin sensitivity and scale back urge for food by a number of mechanisms. That features slowing how shortly meals leaves the abdomen, prompting the pancreas to launch insulin when blood sugar is excessive and suppressing the discharge of a hormone that raises blood sugar.
The burden loss attributable to GLP-1s additional helps enhance insulin sensitivity.
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Early outcomes from Cree’s ongoing examine assist the concept that GLP-1s might decrease testosterone.
The trial, which started in 2023, follows women and girls ages 12 to 35 with weight problems and PCOS who’re on or off Metformin. The examine is designed to manage semaglutide to sufferers for 10 months, and look at their weight reduction, metabolic adjustments and enhancements in reproductive perform.
Cree hopes the trial will reply whether or not GLP-1s can enhance ovulation in ladies with PCOS. Many ladies with PCOS do not ovulate recurrently, which might result in irregular durations and problem getting pregnant.
Cree has preliminary information on 11 ladies who accomplished the ten months on semaglutide and weren’t on Metformin. She mentioned eight of them misplaced greater than 10% of their physique weight and noticed a discount of their testosterone ranges.
5 out of the eight sufferers had their testosterone ranges attain “regular ranges,” Cree mentioned. In the meantime, six out of the eight sufferers reported extra common durations.
Cree mentioned her trial will finally have information from 40 ladies, however she remains to be enrolling sufferers within the group that takes Metformin. She mentioned it would possible take two years earlier than she publishes the primary outcomes from the examine, which can concentrate on the variations in outcomes between youngsters and adults who solely acquired semaglutide.
She mentioned evaluating the teams is essential as a result of hormones that management progress are launched throughout puberty, which may change how youngsters reply to GLP-1s.
Not all ladies with PCOS will profit from taking a GLP-1. Cree mentioned in her trial, three sufferers who accomplished 10 months on semaglutide didn’t lose a minimum of 10% of their physique weight. A kind of ladies didn’t shed some pounds in any respect, she mentioned.
Cree mentioned that is according to earlier research on GLP-1s in adults with weight problems.
Regardless of the promise of GLP-1s in bettering signs, extra analysis can be wanted on PCOS itself, mentioned Dr. Karen Tang, an OB-GYN and founding father of Thrive Gynecology. She mentioned some individuals can expertise hallmark signs of the situation, similar to facial hair and zits, regardless that they’ve regular ranges of testosterone.
“There’s nonetheless rather a lot that is very a lot unknown about PCOS and precisely how the illness type of works,” Tang informed CNBC.
GLP-1s give some sufferers a giant enhance
Anecdotal proof suggests GLP-1s might handle extra than simply weight points for individuals with PCOS. In a latest survey of 1,700 individuals by the contraception app Pure Cycles, 64% of ladies with PCOS who took a GLP-1 reported extra predictable durations, and 20% mentioned their bleeding days had been shorter.
Some sufferers with PCOS may lose extra weight on GLP-1s than these with out the situation, mentioned Dr. Kerry Krauss, an OB/GYN and medical director at Pure Cycles, who has PCOS herself.
Analysis wants to verify these advantages, however she mentioned it offers hope to many PCOS sufferers who’re pissed off with frequent remedies for the situation. These choices sometimes goal only one facet of PCOS, similar to decreasing androgen ranges with sure kinds of contraception.
Tang added that weight loss program and train alone usually fall in need of addressing signs: “Lots of people can train very aggressively and recurrently or watch what they eat and nonetheless battle with hormone imbalances, weight, and blood sugar.”
Haley Sipes a affected person with PCOS taking GLP-1s.
Courtesy: Haley Sipes
That was the case for Haley Sipes, a 31-year-old mom of three primarily based in Western Kentucky who skilled PCOS signs for years with out a analysis. In 2022, earlier than being identified, she misplaced 75 kilos over 10 months by weight loss program and train alone.
Her progress stalled in late 2022 regardless of an intense weight loss program and train routine, and her weight started to fluctuate in 2023. By mid-2024, she had regained about 30 kilos.
Sipes sought assist from her main care supplier and underwent blood work, which revealed she had a hormonal imbalance. Preliminary efforts to control her hormones with progesterone and testosterone had a restricted impact.
Additional bloodwork identified Sipes with PCOS and insulin resistance, which she views as the basis reason behind her weight reduction struggles. She recalled bloating, fatigue, low vitality, and water retention throughout earlier efforts to shed some pounds.
Regardless of her historical past of painful, irregular durations and ovarian cysts since age 10, her suppliers by no means talked about PCOS as a attainable analysis.
In September 2024, her physician prescribed Zepbound. Her insurance coverage lined it on account of her BMI and prediabetes standing.
Sipes mentioned she observed adjustments inside the first month: her meals cravings quieted, her irritation decreased, she skilled much less joint ache, and her interval grew to become much less painful and occurred extra recurrently. Sipes added that she has not had ovarian cysts since beginning Zepbound.
After round eight months on the remedy, she misplaced greater than 60 kilos. Sipes mentioned these outcomes considerably improved her emotional well being.
“All of the signs and being obese may not seem to be massive issues, however when you have got 20 little issues which might be continually nagging you, then you are going to be in a foul temper typically,” Sipes mentioned.
“I am only a higher model of myself once I’m not managed by meals ideas and hormonal points that trigger temper swings,” she continued. “My life does really feel a lot extra gratifying.”
Sipes plans to proceed taking Zepbound to take care of her outcomes, presumably at decrease doses. She famous that extra analysis is required on whether or not PCOS signs can totally resolve.
Insurance coverage protection is a problem
Insurance coverage protection is at the moment the most important hurdle stopping PCOS sufferers from accessing GLP-1s, mentioned Dr. Alyssa Dominguez, an endocrinologist with Keck College of Drugs on the College of Southern California. She mentioned many PCOS sufferers are eligible to make use of GLP-1s for his or her accredited makes use of primarily based on BMI or associated circumstances, however might not have protection.
A couple of-third of employers now cowl GLP-1s for each weight reduction and diabetes, whereas 55% solely cowl them for diabetes, in keeping with a latest survey from the Worldwide Basis of Worker Profit Plans.
In April, President Donald Trump rejected a Biden administration plan that might have required Medicare and Medicaid to cowl weight problems medicine.
Nabeelah Karim is a affected person with PCOS who took GLP-1s to handle her signs.
Courtesy: Nabeelah Karim
Some sufferers, like 34-year-old California mother Nabeelah Karim, have turned to different choices.
Karim was identified with PCOS at 19 and took contraception on and off till giving start in 2021. She mentioned she struggled with hair loss, irregular durations, debilitating cramps, facial hair progress, extreme water retention and temper swings.
Karim mentioned her interval signs worsened after she gave start, and in late 2023, she started what could be a painful five-month-long interval. Docs steered that she shed some pounds, take painkillers or return to contraception.
Whereas Karim misplaced some weight by weight loss program and train, she was finally prescribed Eli Lilly’s diabetes drug Mounjaro by the digital well being startup Noom in April 2024.
Her lengthy interval stopped and signs eased inside days, and he or she started to lose extra weight over time.
“It had solved all the issues that I had skilled for years up till that time,” Karim mentioned.
However her insurance coverage plan by no means formally accredited or denied protection of Mounjaro, forcing her to pay its greater than $1,000 monthly out-of-pocket value. She finally discovered a third-party compounding pharmacy that accepted her prescription, permitting her to purchase a less expensive however unapproved model of the drug.
Karim used that compounded model for six months and continued to expertise weight reduction and enhancements to her PCOS signs.
Throughout FDA-declared shortages, pharmacists can legally make compounded variations of brand-name medicines. They will also be produced on a case-by-case foundation when it is medically mandatory for a affected person, similar to after they cannot swallow a capsule or are allergic to a selected ingredient.
However Novo Nordisk, Eli Lilly and a few well being specialists have pushed again – and in some instances, taken authorized motion – towards the observe, largely as a result of the FDA doesn’t approve compounded medicine. The FDA has declared U.S. shortages of each firms’ medicine over.
“When individuals ask about how secure compounded medicine are, the reply I sometimes give is I do not know,” mentioned Dominguez from USC’s College of Drugs. She mentioned that is in contrast to branded medicine, which have clearly outlined dangers and advantages confirmed in scientific trials.
Hamilton, the 27-year-old affected person who took a GLP-1 for PCOS signs, has by no means taken a compounded GLP-1. She is at the moment interesting her insurer’s denial of semaglutide now that she has accomplished Cree’s trial.
“My entire life has been an lack of ability to entry take care of my medical situation, and I am uninterested in that,” she mentioned. “If anyone would have been capable of present 11-year-old Grace with this drug, that might have saved me.”
