Can Wegovy impact your menstrual cycle?

Introducing a new medication inevitably comes with a host of questions: what are the side effects? How could it influence my weight loss journey? And can it impact my menstrual cycle?

If you’ve just started taking Wegovy for weight loss, or you’re in the process of researching it, you might wonder whether it’ll affect your monthly flow.

Let’s explore the potential link between Wegovy and periods.

The impact of semaglutide on your hormones

The whole point of a Wegovy pen is to help regulate your hormones, namely the one responsible for appetite control.

Wegovy contains an active ingredient known as semaglutide — a compound that mimics glucagon-like peptide-1 (GLP-1). GLP-1 is a hormone produced in your digestive system when you eat, and it assists with managing hunger and blood sugar control.

When semaglutide is injected under your skin, your body uses it to activate the GLP-1 receptor.

This  encourages your pancreas to increase insulin production and reduce glucagon secretion — helping to curb high blood sugar.[1]

GLP-1 also suppresses your appetite and makes you feel more satiated by interacting with the part of the brain that regulates hunger.

When you take semaglutide, it can reduce the secretion of the hunger hormone known as ghrelin, allowing you to feel satisfied after eating a smaller portion of food.

Lastly, semaglutide interacts with the hormones in your gastrointestinal system and helps to slow gastric emptying (the process of food leaving your stomach), making you feel fuller for longer.

Semaglutide may also affect other hormones that aren’t related to your digestive system and blood sugar, but we’ll explore these below.

Can Wegovy affect menstrual cycles?

Even though there’s no clinical evidence that Wegovy can impact your periods, it’s still certainly possible.

Some women who take Wegovy (or Ozempic, which also uses semaglutide as its main ingredient) report irregular or skipped periods, changes to their flow, or even a temporary pause in their cycle. 

However, the reason why this happens is mostly due to the weight loss associated with Wegovy, not semaglutide itself. 

When you lose a significant amount of weight — as can happen with semaglutide use — it can impact your hormonal balance, namely oestrogen and progesterone.

These are the two hormones involved in ovulation and menstruation, collectively known as your menstrual cycle.

Looking specifically at oestrogen, research shows that significant weight loss can lower your oestrogen levels [2].

Your oestrogen levels fluctuate naturally during your menstrual cycle, however, a prolonged decrease of this all-important hormone can lead to irregular or missed periods, as well as other symptoms like vaginal dryness and hot flashes.

Losing a lot of weight in a short amount of time can be particularly disruptive to your menstrual cycle, leading to a condition known as amenorrhea (absence of menstruation) [3].

After rapid weight loss, your body thinks you’re going into a starvation state and responds by effectively suppressing your reproductive system.

While all of this is a very real possibility when taking Wegovy, not everyone notices changes to their menstrual cycle.

Plus, if you do start experiencing irregular or missed periods, you may find that your cycle returns to normal over time. It can take a while for your body to adapt to taking Wegovy, and once it does, your periods may go back to their usual rhythm.

It’s also worth noting that being overweight or obese can lead to menstrual dysfunction [4], so losing weight with Wegovy may actually result in a more predictable cycle.

Is there a link between Wegovy and fertility?

There may indeed be a connection between Wegovy and fertility, but once again it has less to do with the medication itself and more to do with its effects — specifically, its potential for weight loss.

Research shows there’s a strong correlation between obesity and infertility.

Women who are overweight or obese are at greater risk of having an irregular menstrual cycle and anovulation (absence of ovulation) and also have a higher chance of fertility issues like trouble conceiving, pregnancy complications, and miscarriage [4].

There are many reasons for this, including the fact that carrying excess weight affects the hormones that allow you to get pregnant, like oestrogen.

On the other hand, there’s plenty of evidence indicating that losing weight, even a tiny bit, can improve fertility.

One study found that obese and infertile women who lost just 10kg experienced significantly improved pregnancy outcomes, with a miscarriage rate of 18% after losing weight compared to 75% before losing weight [5].

Weight loss can also help restore hormonal balance, lower insulin resistance, and stabilise blood sugar levels — all of which can support fertility [6].

Plus, there’s evidence that all of the lifestyle changes associated with weight loss, like improved diet, increased exercise and reduced stress, can support fertility, too [7][8][9].

Can Wegovy cause a false positive pregnancy test? 

Pregnancy tests work by measuring the amount of human chorionic gonadotropin (hCG) in your urine — the hormone your body produces after the egg attaches to your uterine lining. A high hCG level indicates that you’re pregnant.

While home pregnancy tests are generally pretty accurate, there are times when they display a false positive — aka when the test says you’re pregnant but you’re not.

There are many reasons this can happen, but taking Wegovy isn’t one of them. 

Semaglutide doesn’t affect your hCG levels, nor does it contain hCG as some weight loss medications do. If you’re getting a false positive, it’s more likely due to other factors such as user error, chemical pregnancy (very early pregnancy loss) or certain medical conditions, like ovarian cysts.

On the topic of pregnancy, it’s important to note that Wegovy shouldn’t be taken if you’re pregnant.

Experts recommend you stop taking it about 2 months before you get pregnant to give your body ample time to eliminate it [10].

How to manage menstrual irregularities

If you’ve got an unpredictable cycle, there are a few things you could look into, from lifestyle changes to medication.

Monitor your cycle

Using a period tracker can help you look for patterns in your cycle, such as cycle length, ovulation timing, and the strength of your flow.

You could also track other variables like your diet, exercise, mood, and stress levels to see if there are any potential correlations between your lifestyle and menstrual health.

This information can also be shared with your doctor or another healthcare provider like a gynaecologist, who can assess your cycle and provide guidance accordingly.

Maintain a healthy diet

There are lots of good reasons to eat a healthy diet, and your cycle may be one of them. Food can have a huge impact on your hormonal health, which inevitably affects your periods and the regularity of your cycle.

Foods to focus on include vegetables, complex carbs, protein, and healthy fats. Good fats especially are essential for keeping your cycle consistent.

Foods to avoid include sugar, trans fats, and alcohol — all of which can cause inflammation in the body and potentially contribute to hormonal imbalances and irregular periods [11].

It’s also worth mentioning that crash dieting and incredibly restrictive calorie intake should absolutely be avoided.

Not only can they wreak havoc on your metabolism and energy levels, but they can also mess with your periods. The reason is that they disrupt the hormones required for ovulation, and if you don’t ovulate, you don’t have a period [12].

Exercise regularly (but don’t overdo it)

Exercise is a great habit to get into because it boosts your mood, keeps you fit, and supports your overall health. 

It can also keep your hormones in check, plus some research demonstrates that it may even ease period cramps, with painful periods shown to be less common in women who exercise regularly [13][14].

However, overdoing it can lead to missed periods or periods that stop altogether — something that many athletes experience. Make sure you stick to moderate activities like walking, cycling, swimming, or yoga, particularly if you’re new to exercise.

Keep your stress in check

When you’re stressed, your body releases cortisol — the hormone behind the fight or flight response.

A bit of cortisol isn’t necessarily a bad thing (it does help you respond to the immediate challenge in front of you, after all), but it can negatively impact your menstrual cycle.

This is because it disrupts the hypothalamic-pituitary-gonadal (HPG) axis — the system responsible for regulating your reproductive hormones. When this happens, your period may be late, you may skip a period or, if the stress is chronic, you may go a long time without experiencing one.

Do your best to keep your stress levels under control. Consider stress reduction techniques like yoga, deep breathing, and meditation.

Chat with your doctor about underlying health conditions

Several health conditions can cause erratic periods, including polycystic ovary syndrome (PCOS), thyroid imbalance, endometriosis, perimenopause, uterine fibroids, and pelvic inflammatory disease. 

If you suspect this is the case, or you’re unsure of the root cause of your menstrual irregularity, reach out to your doctor. They can assess your symptoms and develop a plan to manage your condition.

Look into medication

Lifestyle changes may not be enough to fix a fluctuating cycle, in which case you could talk to your doctor about medication to regulate it.

Some of your options include:

The pill

Hormonal contraception, like the pill, can make your cycle more predictable. It can be especially helpful if you’re living with a condition like PCOS or endometriosis.

There are other hormonal contraception options, too, like the hormonal IUD, the contraceptive patch, and the vaginal ring.

Hormone therapy

Hormone therapy involves supplementing or balancing oestrogen and/or progesterone, and it’s typically advised for women experiencing irregular periods as a result of perimenopause.

(Bonus: it can also aid other perimenopause symptoms like vaginal dryness and hot flashes!)

Metformin

This is actually a drug used to treat type 2 diabetes, but it’s been found to have many other benefits — including regulating periods in women with PCOS.

Maintain a healthy weight — or lose weight if you need to

Both low and high body weight can contribute to unpredictable periods, while a healthy weight can help balance your hormone levels and keep your cycle regular. 

If you need to lose weight, many of the lifestyle changes mentioned above may be beneficial — such as maintaining a good diet, exercising, and reducing stress.

You could also consider a weight loss programme like Juniper’s Weight Reset.

Combining health coaching, expert advice from dietitians and clinicians, and GLP-1 weight loss medication, it’s an all-in-one solution that won’t just help you lose weight but potentially get your cycles back to normal, too.

Image credit: Madrona Rose via Unsplash