Wegovy for PCOS: Does it work?

Key points

• Wegovy is not approved to treat PCOS. However, some doctors prescribe it off-label
• Losing 5%-10% of body weight can reduce insulin resistance and regulate menstrual cycles for those with PCOS
• Weight loss on Wegovy may help alleviate PCOS symptoms
• Managing PCOS requires a focus on diet, exercise, sleep, and medication, if necessary

If you're one of the millions living with PCOS (Polycystic Ovary Syndrome), you know how frustrating the symptoms can be. Irregular or missing periods, difficulty getting pregnant, unwanted facial and body hair, persistent acne, thinning hair, and weight that seems impossible to lose.

Even if your doctor tells you to shed the extra pounds, PCOS makes it hard to lose weight. Having PCOS elevates insulin levels, which promote fat storage. It's a vicious cycle that leaves many women feeling defeated.

Can new GLP-1 weight loss drugs like Wegovy or Zepbound offer hope for women with PCOS?

What is PCOS?

Obstetrics and Gynecology (OB/GYN) physician Gia Eapen, MD, explains, “Polycystic ovary syndrome (PCOS) is a hormonal condition affecting women of reproductive age. Your body produces excess male hormones (androgens), which lead to hormonal imbalances.”

Symptoms may vary. You may experience irregular periods, fertility issues, stubborn weight gain, excess hair in unwanted places, and thinning hair.

Does Wegovy work for PCOS?

First of all, it’s important to know that Wegovy (semaglutide) is not approved by the FDA to treat PCOS. It is, however, approved as a weight loss drug for adults with obesity and weight-related issues.

Since excess weight is tied to PCOS, some doctors prescribe Wegovy off-label to help alleviate symptoms of PCOS.

Here are 2 ways someone with symptoms of PCOS may benefit from a semaglutide medication like Wegovy:

1. Weight loss can help with PCOS

Research shows that dropping even 5-10% of your weight can improve many aspects of PCOS, including irregular cycles and overall well-being.

This is where Wegovy could help. In broader clinical trials, people experienced an average 15% weight loss on Wegovy over a year and a half.

More specifically, one study evaluated semaglutide (Wegovy's active ingredient) in women with obesity and PCOS who hadn't responded to lifestyle changes. The results were encouraging: nearly 80% lost at least 5% of their body weight and experienced better blood sugar control and more regular periods.

2. Reducing insulin resistance helps with PCOS

Insulin is a hormone that tells your cells to absorb sugar from your blood for energy. When you develop insulin resistance, your cells stop responding to insulin's signals. To compensate, your pancreas pumps out far more insulin than usual.

“Excess insulin can trigger the ovaries to make more androgens (male sex hormones),” explains Eapen, MD. “This hormonal imbalance can disrupt your menstrual cycle and prevent ovulation. Weight loss lowers insulin resistance. As you shed the pounds, your cells become more responsive to insulin. Then, ovaries produce fewer androgens, and periods may become more regular.”

This is why Wegovy's weight loss effects may help with PCOS. Even 5% weight loss can make a difference in PCOS symptoms and hormone balance.

How long does it take for Wegovy to work for PCOS?

Since Wegovy targets excess weight rather than PCOS directly, let’s discuss the timeline for weight loss with Wegovy.

• Wegovy begins to reduce appetite within 2 weeks
• In 4-5 weeks, appetite suppression becomes consistent
• Studies show an average 2% weight loss by 4 weeks and 4% by 8 weeks
• Research shows an average of 15% weight loss over 68 weeks with lifestyle changes

💡Tips to manage PCOS

Managing PCOS needs more than medication. Here are some lifestyle changes that can help.

1. Make changes to your diet

What you eat can significantly impact your PCOS symptoms.

Experienced Registered Dietitian, Rita Faycurry, RD’s advice:

• Prioritize whole foods, vegetables, lean proteins, and healthy fats to stabilize blood sugar
• Choose whole grains, non-starchy vegetables, and high-fiber options
• Minimize processed foods, sugary drinks, and refined carbohydrates
• Eat balanced meals. Following a diabetes diet is a good starting point because it focuses on lowering insulin resistance

Additionally, a dietitian specializing in PCOS can create a personalized PCOS diet plan addressing your specific needs.

Faycurry, RD, says, "A registered dietitian can work with you to develop sustainable eating patterns that support both weight management and hormone balance. A good PCOS weight loss diet is about finding the foods that help your body work better."

2. Prioritize exercise

Regular physical activity can help address PCOS symptoms. It enhances how your body processes insulin and improves hormone balance.

The CDC recommends 150 minutes of moderate-intensity activity weekly or 75 minutes of vigorous-intensity activity. Brisk walking, swimming, cycling, or dancing work. Resistance training to improve muscle strength is recommended at least twice a week.

3. Get some zz’s

Quality sleep is essential yet often overlooked. Poor sleep disrupts hunger hormones and metabolic function, making everything more complicated.

However, insulin resistance creates another uphill battle. While sleep is important, insulin resistance makes it harder for you to get enough of it! Building a calming sleep routine before bed can help.

4. Talk to your healthcare provider

Talk to your healthcare provider about your PCOS symptoms to determine the best way forward. You could discuss whether a weight-loss drug like Wegovy could help you and if you are eligible to receive the medication.

Beyond Wegovy, other FDA-approved weight-loss options include Zepbound (tirzepatide). Your provider will weigh benefits and risks based on your individual profile.

Final thoughts: Wegovy for PCOS

Living with PCOS is challenging, but treatment options continue expanding. Although Wegovy is not approved to treat PCOS, some doctors prescribe it to help women with PCOS lose weight.

However, along with medication, managing PCOS requires nutritious eating, regular exercise, quality sleep, and medical supervision. Work with your healthcare team to develop a personalized strategy to address PCOS.

Frequently asked questions (FAQs)

Can I get Wegovy for PCOS?

Wegovy is not FDA-approved specifically for PCOS. To be prescribed Wegovy, you must at least meet the minimum criteria: having obesity (BMI ≥30) or being overweight (BMI ≥27) with at least one weight-related health condition. These conditions include type 2 diabetes, high blood pressure, or cardiovascular disease.

Many people with PCOS also have obesity or weight-related conditions. If you meet the criteria, your doctor can evaluate whether Wegovy is appropriate for you. The Wegovy prescription would be for weight loss, not the PCOS itself.

Does Wegovy help with hormonal imbalance?

Wegovy does not directly treat hormonal imbalances. However, the weight loss it produces can indirectly affect hormone levels. When you lose weight, your cells become more sensitive to insulin. Lower insulin levels reduce the amount of androgen your ovaries produce. This chain of effects can improve PCOS symptoms like irregular periods, excess hair growth, and potentially, fertility issues.

Does semaglutide help with PCOS?

Semaglutide, the active ingredient in Wegovy, could help with PCOS symptoms through weight loss. Women who lose significant weight often see improvements in menstrual regularity and metabolic health. Research shows meaningful benefits when people with PCOS lose at least 5% of their body weight. However, please note that semaglutide is not FDA-approved specifically for treating PCOS.

Get a personalized PCOS weight loss diet plan from a dietitian who accepts your 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.