Can Ozempic help with PCOS?

Since Ozempic was approved by the FDA in 2017, it’s been a game changer in helping people manage their type 2 diabetes and related metabolic issues like overweight and obesity. But the possible health benefits don’t appear to stop there and researchers keep discovering new (off-label) uses for Ozempic. 

Polycystic ovarian syndrome (PCOS) may end up being one of those new uses for Ozempic. According to some early information, the drug may be able to help alleviate symptoms of PCOS.

Ozempic is the brand name of a medication called semaglutide, and it’s approved to help people manage their type 2 diabetes by stabilizing blood sugar levels and prompting weight loss. Ozempic is a once-weekly subcutaneous injection (which means that it’s injected just under the skin) that people can self-administer using a preloaded injector pen. While it’s currently approved to treat type 2 diabetes, it’s often prescribed off-label to help with weight loss.

Ozempic is part of a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs work by mimicking the action of a natural, appetite-regulating hormone, GLP-1, but their effects last much longer—nearly a week, as opposed to the few minutes that GLP-1 normally lasts.

This triggers various actions that help the body regulate blood sugar and lose weight. Ozempic achieves this by:

• Stimulating the release of insulin, which helps to reduce blood sugar

• Slowing down gastric emptying (how fast food moves through the stomach), which decreases appetite, increases satiety, and reduces how much sugar gets released into the bloodstream

While Ozempic wasn’t developed or approved for treating polycystic ovarian syndrome (PCOS), it and similar drugs may be promising tools to help some people manage PCOS symptoms if prescribed off-label.

It helps to start with a basic understanding of the disorder. PCOS is a common endocrine disease—in fact, it’s the most common endocrine disease experienced by women, affecting up to 15% of women between puberty and menopause worldwide.

It’s not clear what causes PCOS, and diagnosing it can be a long, frustrating process for people because it looks like many other conditions which have to be ruled out first. PCOS is also not a disease with a cure; instead, treating it consists of managing its symptoms.

Up to 70% of people with PCOS also have abdominal obesity, and what’s more, PCOS is commonly associated with comorbidities that include type 2 diabetes, cardiovascular disease and hypertension. This means that some of the key hallmarks of PCOS—type 2 diabetes, and obesity —are the very conditions that Ozempic is so good at treating. Plus, losing weight is one of the ways people can manage their PCOS symptoms.

However, it is important to keep in mind that Ozempic isn’t a cure-all for women with PCOS. The symptoms of this complex condition can vary from person to person, and not everyone experiences metabolic symptoms like obesity, insulin resistance, and diabetes. In this case, people most likely won’t benefit as much from GLP-1 agonists. 

PCOS symptoms are typically managed with lifestyle adjustments, as no drugs aren’t currently approved to treat PCOS specifically. Lifestyle modifications that can help with symptoms focus mainly on diet and exercise to help people lose weight and regulate their hormones.

Medications can help with some symptoms, too. Depending on the person’s symptoms and health needs, healthcare providers may prescribe some combination of combined oral contraceptive pills, antiandrogen medication (like spironolactone), insulin-sensitizing medication (like metformin), ovulation-inducing drugs (like clomiphene), and even statins.

Enter Ozempic. Increasingly, researchers and healthcare providers are exploring GLP-1 receptor agonists like Ozempic as another medical tool that can help to alleviate PCOS symptoms.

This is because losing weight and regulating blood sugar are considered crucial to managing PCOS. While the exact relationship between PCOS and its associated health problems like obesity and hormonal imbalance is complex, weight loss with PCOS is associated with improvements in many PCOS symptoms.

Studies have shown that, among women with PCOS, losing weight can:

• Improve reproductive function

• Improve blood sugar regulation

• Reduce excess androgen hormones

• Lower cholesterol

• Improve hypertension

Interestingly, semaglutide-based drugs like Ozempic are gaining popularity among young women suffering from PCOS through anecdotes shared on social media. Considering the dearth of tools available to treat PCOS, it’s perhaps understandable that young people are motivated to find other options to alleviate their symptoms. But while Ozempic may present exciting possibilities for people with PCOS, it isn’t yet approved for people under age 18.

However, given the prevalence of both obesity and PCOS in adolescents, future approval of similar drugs could offer a chance to help young women manage these conditions early on.

Insulin resistance is a situation where a person’s body can’t use insulin effectively, and therefore can’t regulate their blood sugar. Insulin, a key hormone created in the pancreas, is responsible for helping move sugar in the body's cells to make energy. 

With insulin resistance, the pancreas still makes insulin, but the body can’t use it to put away excess blood sugar. This means that blood sugar stays high and much of the excess blood sugar gets stored as fat cells, increasing body weight and the risk of obesity.

PCOS and insulin resistance frequently go hand in hand. It’s estimated to affect between 50% and 70% of people with PCOS. This is important for long-term health, as insulin resistance is not only associated with type 2  diabetes, but also issues like hypertension, cholesterol, obesity, and liver disease, among others.

For this reason, blood sugar regulation is vital for managing insulin resistance with PCOS, improving obesity, and avoiding progression into more serious health problems. Lifestyle changes, including diet and exercise, are common first-line recommendations to help people to regulate their blood sugar, but sometimes that doesn’t work.

In these cases, healthcare providers often prescribe people with PCOS a diabetes drug called metformin to regulate blood sugar.  

Ozempic and other semaglutide-based medications often cause some minor side effects, but most people find that they are manageable and subside with time; during clinical trials, less than 4% of people stopped taking Ozempic because of side effects. They also tend to be most noticeable when people increase their dosage.

Most side effects are gastrointestinal in nature, and include:

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

• Constipation

PCOS is a common disorder for women of reproductive age, and many experience a degree of obesity, diabetes, and insulin resistance. Insulin resistance is commonly linked with PCOS, which may also be one of the reasons why medications like Ozempic—which can increase insulin sensitivity and help you lose weight—may help with PCOS symptoms. 

Despite evidence pointing to Ozempic being a promising tool in the treatment of PCOS symptoms, GLP-1 drugs are currently only approved by the FDA to treat diabetes and overweight or obesity. If your healthcare provider thinks Ozempic or other GLP-1 medications might help you manage PCOS symptoms, they will prescribe the drug off-label.

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Current version

July 20, 2023

Written by

Nancy LaChance, BSN, RN

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.