Are Ozempic side effects more common in females?

Ozempic (semaglutide) is a prescription medication that’s FDA-approved for both managing blood sugar in adults with type 2 diabetes and for reducing the risk of cardiovascular events in adults with type 2 diabetes and cardiovascular disease. If you’ve been taking Ozempic, you’re probably familiar with its side effects. You may be experiencing some “fun” gastrointestinal upset, including nausea and vomiting, as your body gets used to the medication. The good news is that many of these side effects should subside with time. 

Individual experience with Ozempic side effects can vary. Interestingly, some studies show that females may be more likely to have certain side effects than males using Ozempic. (Note: in this article, we use the terms male and female to refer to sex assigned at birth.)

Read on as we break down the Ozempic side effects females can expect.

Yes, some Ozempic side effects may be more common in females vs. males. However, we don’t know for sure, as most of the research to date has focused on the side effects of GLP-1 receptor agonists in general (the class of drugs that includes Ozempic), as opposed to the side effects of Ozempic specifically. This drug class also includes other medications for type 2 diabetes or weight loss, such as Wegovy and Mounjaro. Some research has found that females taking GLP-1s are about twice as likely to experience side effects than males. Moreover, females may be more likely to experience gastrointestinal side effects like nausea and vomiting, as well as headache and dizziness. 

Researchers suspect this could be due to a number of reasons, from hormonal to anatomical differences between the sexes. Females are also more likely to experience gastrointestinal disorders in general. 

Side effects of Ozempic 

Regardless of sex, Ozempic primarily causes gastrointestinal side effects. Many of these side effects are more intense in the beginning, and go away with time as your body gets used to the medication. Here’s a quick look at the most common side effects of Ozempic overall, and how many people (both male and female) reported them in clinical trials:

The research on how sex differences can affect Ozempic side effects is still ongoing. Part of the challenge is that many studies on GLP-1s and Ozempic include a majority (75% or more) of female participants, and researchers don’t always parse out the side effects experienced by male vs. female participants. Having said that, the research done thus far does suggest that females taking GLP-1s may be twice as likely to experience side effects in general. More specifically, they may be more likely to experience headache, dizziness, nausea, and vomiting.

Headache

In one study of GLP-1 drugs (but not Ozempic specifically), females were almost eight times more likely to report headache than males.

Headache can be a sign of hypoglycemia (low blood sugar), which can be more likely to happen if you are taking Ozempic with another medicine that can cause low blood sugar, such as insulin or sulfonylureas. Other signs of low blood sugar include:

• Dizziness

• Sweating

• Confusion

• Blurred vision

• Slurred speech

• Shakiness

• Fast heartbeat

• Irritability or mood changes

• Hunger

• Weakness

• Feeling jittery 

Dizziness

In the same study, females were about 3.5 times more likely to experience dizziness when taking GLP-1s than males. In clinical trials of Ozempic, dizziness was rare overall.

Like headache, dizziness can be a sign of low blood sugar, which can be more likely to happen when you take a blood-sugar-lowering medicine like insulin while using Ozempic. Dizziness can also be a sign of an allergic reaction. If you notice any of the following, seek emergency medical attention immediately:

• Swelling of the face, lips, tongue, or throat

• Trouble swallowing or breathing

• Severe rash or itching

• Fainting

• Very rapid heartbeat

Nausea and vomiting

The same study found that females were about 4.5 times more likely to experience vomiting when taking GLP-1 drugs. Other studies of GLP-1 drugs generally (but not Ozempic specifically) have found similar findings. Females were more likely to experience gastrointestinal side effects in general, including nausea and vomiting. 

In the studies we reviewed, researchers didn’t hypothesize why females were more likely to experience headache and dizziness on GLP-1s. However, they suggested a number of reasons why females may experience more nausea and vomiting on Ozempic and similar medications.

For one, females are more likely to experience GI disorders in general. “The sensitivity to GI side effects of GLP1s may be more pronounced in women because they already have a longer gut transit time compared to men,” says Beverly Tchang, MD, Obesity Medicine Advisor for Ro and assistant professor of Clinical Medicine at Weill Cornell Medicine in New York. In other words, Dr. Tchang says, “[a] slower gut may predispose them to constipation and reflux.”

Researchers also hypothesized that the lower average body weight of females (when compared to males) allows for more exposure to the drug’s active ingredient. Indeed, in studies of GLP-1 drugs, those who used higher dosages were more likely to report gastrointestinal side effects.

Another factor could be anatomical differences between females and males. For example, some studies show that females tend to have slightly more insulin-producing beta cells in their pancreas. GLP-1 medications like Ozempic directly work on the pancreas by encouraging it to release more insulin when your blood sugar levels get too high.

While rare, serious side effects can happen on Ozempic. These include pancreatitis (inflammation of the pancreas), diabetic retinopathy (diabetes-related vision changes), hypoglycemia, serious allergic reactions, gallbladder disease, and kidney problems. When it comes to the serious side effects of Ozempic, studies have found that females and males are equally likely to experience them. 

According to a growing body of research, women may be more likely than men to experience long-term results with Ozempic. 

For example, in one study, females taking Ozempic lost a little over 5% of their baseline body weight in one year, while males only lost 3.66%. Females were also significantly more likely to meet the weight loss benchmarks of 5% and 10% weight loss. The researchers hypothesized this could be due to differences in body compositions between the sexes regarding muscle mass vs. fat.

Hormonal differences could be another reason why. GLP-1 medications like Ozempic affect your brain’s food-reward center, which influences both your appetite and food cravings. It turns out that estrogen levels also affect your food cravings, which explains why food intake tends to vary throughout the menstrual cycle. Since females have higher estrogen levels than males, that may explain why they respond differently to GLP-1 drugs like Ozempic. 

Females with diabetes and heart disease may also experience a greater reduction in the risk of cardiovascular problems, such as a heart attack, when they take Ozempic. In general, men are more likely to experience a major cardiovascular risk. But among people with diabetes, women are more likely, and some studies have found that women experienced a greater risk reduction when taking GLP-1 diabetes medications. Researchers concluded this could be because females have a lower average body weight compared to males, which allowed for more exposure to the drug. 

Most people experience gastrointestinal side effects within one week to one month of starting Ozempic. These side effects may include nausea, vomiting, diarrhea, constipation, or abdominal pain. Typically, Ozempic side effects last for 8–12 weeks, during the time when you are gradually increasing your dose. Ozempic follows a dose titration schedule, where people start at a low 0.25 milligram dosage and ramp up to their final maintenance dosage over 12–16 weeks. 

After those first few months have passed and your body has acclimated to your maintenance dosage, the GI side effects should start to die down. For example, nausea is Ozempic’s most common side effect, affecting up to 20% of people. In one study, around 13% of people reported nausea within the first three months of taking Ozempic. Six months later, fewer than 2% of people were still experiencing nausea. 

You can always ask your healthcare provider for tips on managing Ozempic side effects. But, the strategies below seem to be the most helpful for people experiencing nausea, vomiting, diarrhea, and constipation.

Change up your diet

Improving your diet can help you reach your weight loss goals. Turns out, it can also help relieve many of the troublesome side effects of Ozempic, including nausea, diarrhea, and constipation. 

If you’re experiencing nausea, low-fat, bland foods like crackers and rice can offer relief. Fried, fatty foods can worsen nausea, so opt for healthier cooking methods instead, such as boiling or baking. Apples, mint, and ginger root can also relieve nausea on Ozempic.

If you’re experiencing diarrhea, avoid foods that contain dairy or artificial sweeteners. Also limit your intake of coffee, soft drinks, and alcohol. Until your diarrhea goes away, temporarily reduce your fiber intake. Instead, eat chicken broth, rice, carrots, and ripe fruit (without the skin) to improve your stool. Once your diarrhea resolves, you can slowly add more high-fiber foods back into your diet.

If you’re experiencing constipation, you’ll actually want to increase the amount of fiber in your diet. Fiber-rich foods include whole grains, nuts, seeds, fruits, and vegetables. 

Slow down during meals

Changing what you eat can help you manage Ozempic side effects. So can changing how you eat. Follow these tips to relieve gastrointestinal side effects on Ozempic:

• Eat slowly and mindfully, focusing on how the food tastes.

• Eat smaller meals, more frequently as opposed to larger meals, less often.

• Only eat when you’re hungry, and stop eating once you feel full.

• Avoid eating too close to bedtime, and don’t lie down after you eat.

Stay hydrated

Staying hydrated is a good idea in general, but it’s especially important for people experiencing fluid loss due to vomiting and diarrhea on Ozempic. 

Drink plenty of water, but take care to drink it in small sips to avoid feeling too full. You can further increase your water intake by eating water-rich foods such as soups, yogurt, and gelatin. Adding a squeeze of lemon can be helpful for people dealing with diarrhea. 

If you’re experiencing frequent nausea or vomiting, avoid drinking liquids during meals. Instead, drink water or other liquids about 30–60 minutes before or after you eat.

Get some fresh air (and exercise)

Increasing your physical activity in general can help with weight loss, and it can also relieve constipation on Ozempic. Plus, Ozempic is supposed to be used in combination with diet and exercise. 

If you’re experiencing nausea, light exercise after a meal may help you feel better. You don’t want to do anything too vigorous, but an easy stroll outside can help relieve nausea on Ozempic.

If you have any concerns about Ozempic side effects, you should contact your healthcare provider. However, there are some cases where you should definitely see a doctor about Ozempic side effects. 

While rare, Ozempic can cause serious side effects. Below we’ve listed the potentially serious side effects of Ozempic, and the warning signs to watch out for. If you experience any of these symptoms, seek medical attention promptly.

Signs of low blood sugar (hypoglycemia)

As a blood-sugar-lowering agent, Ozempic can cause low blood sugar, especially in people with type 2 diabetes who may be taking insulin or sulfonylureas. Signs of low blood sugar include:

• Dizziness or light-headedness

• Sweating

• Confusion or drowsiness

• Headache

• Blurred vision

• Slurred speech

• Shakiness

• Fast heartbeat

• Anxiety, irritability, or mood changes

• Hunger

• Weakness

• Feeling jittery 

Signs of a serious allergic reaction

While rare, some people may be allergic to semaglutide or the inactive ingredients in Ozempic. Signs of a serious allergic reaction include:

• Swelling of the face, lips, tongue or throat

• Difficulty breathing or swallowing

• Severe rash or itching

• Fainting or feeling dizzy

• Very rapid heartbeat

Signs of pancreatitis

Pancreatitis, an inflammation of the pancreas, has been reported in clinical trials of Ozempic. The main warning sign of pancreatitis is severe stomach pain that does not go away. It may or may not be accompanied by vomiting, and you may feel the pain radiate from your stomach to your back. If you experience these symptoms, stop taking Ozempic and contact your healthcare provider.

Signs of kidney failure

Some of Ozempic’s GI side effects can cause fluid loss and dehydration that can worsen kidney problems. If you experience severe diarrhea, nausea, or vomiting, talk to your healthcare provider about how to rehydrate.

Signs of gallbladder problems

Some people may develop gallbladder issues when taking Ozempic, including gallstones and inflammation. If you experience the following symptoms, contact your healthcare provider right away:

• Pain in the upper stomach

• Yellowing of the skin or eyes (jaundice)

• Fever

• Clay-colored stool 

Signs of diabetic retinopathy

Ozempic may increase the risk of diabetic retinopathy (a complication of diabetes that causes vision changes or blindness). Contact your healthcare provider if you notice any changes in your vision, including:

• Blurred vision

• Distorted vision

• Floaters

• Partial or total blindness

• While more research is needed, females may be more likely to experience Ozempic side effects. 

• In particular, they may be more likely to experience nausea, vomiting, dizziness, and headache than males. 

• However, they also tend to experience more weight loss on the medication, as well as a larger reduction in their cardiovascular risk.

If you have concerns about side effects on Ozempic, talk to your healthcare provider.

---

How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

November 20, 2024

Written by

Amelia Willson

Fact checked by

Patricia Weiser, PharmD

---

About the medical reviewer

Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist, health content writer, and medical reviewer with more than a decade of clinical experience in community and hospital pharmacy.