From the Guidelines
GLP-1 receptor agonists, such as exenatide, liraglutide, and semaglutide, have been shown to have variable weight reduction efficacy and corresponding metabolic and reproductive benefits in individuals with PCOS, as demonstrated in a recent systematic review and meta-analysis 1. The interest in using GLP-1 RAs in women with PCOS has increased due to their general efficacy in weight reduction, which can help address insulin resistance, a common issue in women with PCOS.
- Key benefits of GLP-1 RAs in PCOS management include:
- Weight reduction
- Metabolic benefits
- Reproductive benefits, such as improved fertility and menstrual cycle regulation
- Potential reduction in androgen levels, which can help alleviate symptoms like hirsutism and acne
- Typical treatment with GLP-1 RAs involves starting at a low dose and gradually increasing over weeks to minimize gastrointestinal side effects, such as nausea, vomiting, and diarrhea, which typically improve with continued use.
- It is essential to note that while GLP-1 RAs are not FDA-approved specifically for PCOS, they are increasingly used off-label as part of comprehensive PCOS management, and their use is supported by recent evidence, including a systematic review and meta-analysis published in 2024 1.
- The choice of GLP-1 RA and dosage should be individualized, taking into account the patient's specific needs and medical history, and under the guidance of a healthcare professional.
From the Research
Correlation between PCOS and GLP-1
The correlation between Polycystic Ovary Syndrome (PCOS) and Glucagon-Like Peptide-1 (GLP-1) has been studied in various research papers.
- GLP-1 receptor agonists have been found to improve insulin resistance and reduce weight in women with PCOS 2, 3, 4, 5.
- A systematic review and meta-analysis found that GLP-1 receptor agonists were more effective than metformin in improving insulin sensitivity and reducing body mass index (BMI) and abdominal girth in women with PCOS 2, 4.
- Another study found that GLP-1 receptor agonists were associated with a higher incidence of nausea and headache than metformin, but there were no significant differences in other adverse effects 4.
- The use of GLP-1 receptor agonists in combination with metformin has also been studied, with one meta-analysis finding that the combination therapy exhibited similar effects on primary outcomes compared to GLP-1 receptor agonist alone 2.
Benefits of GLP-1 Receptor Agonists in PCOS
The benefits of GLP-1 receptor agonists in PCOS include:
- Improvement in insulin sensitivity 2, 3, 4, 5
- Reduction in BMI and abdominal girth 2, 4
- Potential benefits for women with PCOS who are overweight or obese, glucose intolerant, or have cardiovascular disease risk factors 6
- May be a good option for obese women with PCOS, especially those with insulin resistance 4, 5
Limitations and Future Research
- The quality of the evidence is generally considered low to moderate, and more high-quality research is needed to assess the efficacy and safety of GLP-1 receptor agonists in women with PCOS 2, 4, 5.
- Further prospective randomized controlled trials and cost-effectiveness analyses are warranted to guide the use of GLP-1 receptor agonists in the treatment of PCOS 2.