Can semaglutide (glucagon-like peptide-1 receptor agonist) reduce hormonal food cravings in women during the premenstrual phase?

Semaglutide for Reducing Hormonal Food Cravings During Premenstrual Phase

Semaglutide may help reduce hormonal food cravings during the premenstrual phase through its action on appetite suppression via the hypothalamus, though it is not FDA-approved specifically for this indication.

Mechanism of Action for Food Craving Reduction

• Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that acts on the hypothalamus to suppress appetite, delay gastric emptying, increase glucose-dependent insulin release, decrease glucagon secretion, and increase pancreatic β-cell growth 1
• GLP-1 receptors are found in the central nervous system, which may contribute to the drug's effects on appetite regulation and potentially food cravings 2
• The premenstrual phase is associated with increased vulnerability to food cravings, overconsumption, and sometimes depression, often linked with low serotonin activity 3
• Inflammation may play a role in premenstrual food cravings, with higher inflammatory biomarkers such as hsCRP, IL-6, and others being associated with increased risk of moderate/severe cravings across the menstrual cycle 4

Evidence for Semaglutide's Effect on Food Cravings

• While not specifically studied for premenstrual cravings, semaglutide has demonstrated significant appetite suppression effects in clinical trials for obesity management 1
• In the STEP trials, semaglutide produced mean weight loss of 14.9% at 68 weeks (compared to 2.4% with placebo), indicating powerful appetite-regulating effects 1
• A case report suggests that semaglutide may help manage refractory dysmenorrhea symptoms, potentially through anti-inflammatory and anti-estrogenic properties, which might also impact food cravings 5
• Menstrual cycle studies show that women exhibit greater preference for chocolate foods during menstrual flow and may experience carbohydrate cravings in the premenstrual phase 6, 3

Dosing and Administration Considerations

• For obesity management, subcutaneous semaglutide is typically dosed once weekly 1
• Slow titration of GLP-1 receptor agonists is recommended to improve tolerability of adverse effects 2
• Long-term use may be necessary to maintain benefits, as weight regain (and potentially return of cravings) is common after cessation 1

Potential Side Effects and Contraindications

• Common adverse effects include nausea, vomiting, diarrhea, dyspepsia, and gastrointestinal reflux 2
• Semaglutide can delay gastric emptying, particularly during initial therapy 2
• Contraindicated in patients with history of serious hypersensitivity reactions to the drug 1, 2
• Use with caution in patients with severe renal impairment or end-stage renal disease 1
• Semaglutide has been associated with diabetic retinopathy complications, which may be related to rapid glucose and A1C reductions 1

Clinical Application for Premenstrual Food Cravings

• While not FDA-approved specifically for premenstrual cravings, the appetite-suppressing effects of semaglutide could theoretically help manage these symptoms 1
• The anti-inflammatory properties of semaglutide may be particularly relevant, as inflammation has been linked to premenstrual food cravings 4, 5
• The benefit-risk profile should be carefully considered, as semaglutide is a potent medication with potential side effects 2
• For women who also have obesity or type 2 diabetes, semaglutide may offer dual benefits of managing these conditions while potentially addressing premenstrual cravings 1

Practical Considerations

• Hypoglycemia risk is increased when used with insulin and insulin secretagogues; lower doses of these medications may be required 1
• Patients should be monitored for potential adverse effects, including gallbladder disorders 2
• Weight regain is common when medication is withdrawn, suggesting that extended treatment may be needed for sustained benefits 1