From the Guidelines
Semaglutide may be a beneficial treatment option for polycystic ovary syndrome (PCOS) patients, particularly those with insulin resistance, obesity, or type 2 diabetes, as it has been shown to improve insulin sensitivity, promote weight loss, and potentially regulate menstrual cycles, although more high-quality studies are needed to confirm its efficacy and safety in this population. The use of semaglutide in PCOS is supported by a systematic review and meta-analysis published in 2024 in the journal Obesity Reviews 1, which found that semaglutide led to greater weight loss compared to other anti-obesity agents, including liraglutide and exenatide. Some key points to consider when using semaglutide for PCOS include:
- Starting dose: 0.25 mg weekly by injection, gradually increasing to 1.0-2.4 mg weekly depending on tolerance and clinical response
- Treatment duration: long-term, as stopping the medication often results in symptom return
- Potential benefits: improving insulin sensitivity, promoting weight loss (10-15% of body weight), regulating menstrual cycles, and reducing androgen levels
- Common side effects: nausea, vomiting, diarrhea, and constipation, which often improve over time
- Importance of lifestyle modifications: semaglutide should be used as part of a comprehensive PCOS management plan that includes diet and exercise A study published in 2021 found that semaglutide 1 mg weekly resulted in significant improvements in anthropometric measures, including weight, BMI, and visceral body fat, compared to placebo in PCOS patients 1. However, more research is needed to fully understand the effects of semaglutide on reproductive outcomes, metabolic parameters, and psychological well-being in PCOS patients. Overall, semaglutide may be a valuable treatment option for PCOS patients, but its use should be carefully considered and monitored by a healthcare provider, taking into account the individual patient's needs and medical history.
From the Research
Semaglutide and PCOS
There is limited direct evidence on the use of semaglutide for PCOS. However, some studies suggest that incretin mimetics, a class of medications that semaglutide belongs to, may be beneficial in managing PCOS:
- Incretin mimetics have a unique metabolic target and could be used widely in the management of PCOS 2
- Newer emerging therapies, including twincretins and triple GLP-1 agonists, are promising therapeutic options for treating type 2 diabetes, which has similar metabolic and pathological features to PCOS 2
Alternative Treatments for PCOS
Other treatments have been studied for PCOS, including:
- Metformin, which has been shown to improve insulin sensitivity and weight management in PCOS 3, 4
- SGLT-2 inhibitors, a new class of antidiabetic agents with beneficial cardiovascular, bodyweight, and antihyperglycemic effects, which may be an attractive therapeutic addition in the PCOS armamentarium 5
- Lifestyle modifications, such as weight management and dietary changes, which are the primary therapy for PCOS and can help reduce the risk of metabolic complications 6
Gaps in Research
There are no direct studies on the use of semaglutide for PCOS, and more research is needed to determine its efficacy and safety in this population. Additionally, high heterogeneity of studies on PCOS treatments limits extrapolation of findings, and further research is needed to determine which women will benefit most from different medications 3, 4