Semaglutide for PCOS: Does it work?

Key Points

• Semaglutide is not FDA-approved to treat PCOS
• Some studies, however, show that semaglutide helped women with PCOS lose weight
• Weight loss often helps PCOS symptoms by reducing insulin resistance and hormonal imbalances
• Proper nutrition plays a key role in managing PCOS

PCOS carries serious long-term health consequences, including an increased risk of diabetes, heart disease, and fertility challenges. 

The main treatment approach centers on lifestyle changes, particularly diet and exercise.

Since PCOS is closely linked to insulin resistance, doctors typically recommend weight loss for overweight patients as a way to improve symptoms and reduce health risks.

This is where semaglutide enters the conversation.

Initially developed for diabetes and later approved for weight loss, this medication has proven effective at helping people shed pounds.

So it was only natural that women with PCOS started asking: if weight loss helps PCOS symptoms, and semaglutide helps with weight loss, could this medication help with PCOS management?

Let’s look at what the research shows.

What is PCOS?

"Polycystic ovary syndrome (PCOS) happens when your ovaries make too much of certain hormones called androgens. These are sometimes called male hormones, even though women have them too. When androgen levels get too high in women, it can interfere with how the ovaries function normally, which may lead to cyst formation," explains Gia Eapen, MD, an experienced OB/GYN.

What causes PCOS?

Think of PCOS as your hormones getting out of balance.

"Everything with hormones is many layers deep for the cause, but the biggest factors for PCOS come from high DHEA (a building block used to make other hormones), which leads to symptoms of elevated androgens like testosterone. Insulin resistance also tells the ovaries to produce more androgens. There is also the gut component playing a big role here in how hormones are being eliminated or recycled, which is also impacted by many things, such as stress," explains Emily Kuntz, RD, Registered Dietitian.

What are the symptoms of PCOS?

"The signs of PCOS are irregular hair growth, hair loss on the head, oily skin, acne, and chronic fatigue, being the most common. There's also a large percentage of women who have insulin resistance, low-grade chronic inflammation, irregular menstruation," notes Kuntz, RD.

Weight gain around the midsection is another typical symptom. Additional signs include mood changes, sleep problems, and skin tags. The psychological impact shouldn't be underestimated, as anxiety and depression can accompany these physical effects.

Does semaglutide help with PCOS?

Semaglutide is not FDA-approved for PCOS treatment. As of now, the FDA has approved semaglutide for type 2 diabetes (Ozempic and Rybelsus) and obesity (Wegovy).

However, research is underway to evaluate the impact of semaglutide on women with PCOS.

One study evaluated semaglutide for weight loss in obese women with PCOS who had not responded to lifestyle changes:

• Almost 80% of participants achieved a weight loss of at least 5%.
• Participants experienced a mean weight loss of 16.7 pounds (7.6 kg) and a mean BMI reduction of 3.1
• The study also found that participants had better blood sugar control and more regular periods

Another clinical trial is underway, measuring changes in ovulation frequency, insulin sensitivity, and ovarian morphology (how ovaries look) in women with PCOS treated with semaglutide, assessing outcomes at baseline and 6-10 months after treatment.

In general, PCOS is linked with insulin resistance, and weight loss can help people with PCOS. Apart from medication, diet and lifestyle changes play a strong role in managing PCOS.

How does diet help PCOS?

"Diet and lifestyle changes remain fundamental to PCOS treatment. What you eat can help with PCOS symptoms since a balanced diet can work on the underlying problem in PCOS, insulin resistance. When your body can't use insulin properly, it triggers your ovaries to pump out more androgens (those male hormones that cause PCOS symptoms)," explains Eapen, MD.

A well-balanced diet can help:

• Manage blood sugar levels
• Reduce inflammation
• Support hormone balance

Weight loss and PCOS

One of the most significant benefits of dietary changes is weight loss, which research shows can improve PCOS symptoms.

One study found that losing 5-10% of your body weight can make a difference in PCOS symptoms, from getting regular periods to feeling better mentally and physically.

Another study found that women with PCOS who lost weight through healthy eating and exercise saw improvements in their periods, mood, unwanted hair growth, and overall quality of life.

What foods can you eat with PCOS?

Here are some practical ways to manage PCOS more effectively through your diet.

Choose foods that stabilize blood sugar

Focus on nutrition-dense foods that provide sustained energy. Whole grains, like quinoa, brown rice, and oats, help stabilize blood sugar levels. Include plenty of non-starchy vegetables, legumes, healthy fats from sources like avocados and nuts, and lean proteins.

Avoid foods that spike blood sugar

Avoid or limit foods that can spike blood sugar and worsen insulin resistance. This includes highly refined grains like white bread, white rice, and sugary cereals, as well as foods rich in added sugars such as soda, fruit juices without fiber, candy, and sweetened desserts.

Manage your sweet tooth

When you do want sweetness, choose whole fruits like pears and apples. These provide natural sugars along with fiber that helps slow absorption. Consider limiting your intake of processed, sugary foods.

Be picky about fats

Limit fats from processed meats, like bacon and sausages, which are rich in saturated fats and trans fats, that are associated with chronic disease. Olive oil, avocados, eggs, nuts, and seeds are better choices of fats.

Optimize food combinations

Eating carbohydrates with healthy fats and proteins can help reduce blood sugar spikes and improve insulin resistance. For example, include avocado with your whole-grain toast, or olive oil with pasta.

Watch your portions

Even healthy foods can affect blood sugar if you eat too much at once. Eating balanced, and well-proportioned meals helps keep your insulin levels more stable.

A registered dietitian can develop a personalized approach to nutrition that fits your lifestyle and preferences. They can also help you navigate the many conflicting messages about PCOS.

Final thoughts: Semaglutide for PCOS

Semaglutide is not FDA-approved to treat PCOS. However, studies have shown that it can help with weight loss in obese women with PCOS. While this research is encouraging, it's important to remember that diet and lifestyle changes are essential for managing PCOS.

These foundational approaches address the root causes of insulin resistance and hormonal imbalances that drive PCOS symptoms. Focusing on nutrition, exercise, and stress management will always be crucial parts of your PCOS care plan.

Find a PCOS dietitian who accepts your insurance.

Frequently asked questions (FAQs)

Is semaglutide approved for PCOS?

No, semaglutide is not FDA-approved specifically for PCOS treatment. The medication is approved for type 2 diabetes management (as Ozempic) and weight management in people with obesity (as Wegovy). However, studies have shown that semaglutide can help in weight loss in obese women with PCOS.

What are the best weight loss drugs for PCOS?

Your healthcare provider is the best person to help you determine what might work best for your situation. They'll review your health history and the current issues you're experiencing.

Semaglutide may be an option for weight loss if you have PCOS and are significantly overweight, but only if your doctor thinks it's right for you.

What supplements should I take for PCOS?

"There are lots of supplements that can be taken for managing PCOS. Semaglutide can assist with weight issues, but it will not address the underlying cause of PCOS. So, I do not recommend this for my clients. I would recommend taking a deeper look at the gut, possibly doing a stool test and/or hormone panel to get to the root cause of the symptoms, followed by lifestyle and dietary changes, of course," notes Kuntz, RD.

What is the best diet for PCOS?

Women with PCOS benefit most from eating nutrient-packed foods that help stabilize blood sugar and reduce inflammation. Focus on filling your plate with foods like brown rice and quinoa, fresh fruits with their natural fiber, non-starchy vegetables (such as leafy greens and broccoli), beans and lentils, healthy fats from nuts and olive oil, and lean sources of protein.

A registered dietitian can work with you to create an eating plan that fits your lifestyle, food preferences, and specific PCOS symptoms.

Get your personalized PCOS diet plan, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.