GLP-1 medications, such as those with semaglutide, may help you lose weight that’s gained during perimenopause or menopause. They may have an enhanced effect when combined with menopausal hormone therapy (MHT).

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Glucagon-like peptide-1 (GLP-1) medications have been shown to help people lose weight. They’ve long been used to help people with diabetes maintain a moderate weight.

But they may also help during perimenopause (the time leading up to menopause) and menopause (going 1 year without a period).

During this natural stage of life, weight gain is possible for many people due to changes in metabolism and hormone levels.

A note on weight maintenance

Following a nutritious eating pattern and getting enough exercise are often the first-line treatments for weight gain during menopause. However, losing weight can be difficult due to personal reasons and biology, which can’t be changed. Weight loss medication can be a good adjunct treatment to lifestyle modifications.

Many health experts and scientific research support the efficacy of using GLP-1 medications in weight maintenance.

Semaglutide mimics the effects of GLP-1. This type of GLP-1 receptor agonist can therefore help lower blood sugar and increase feelings of fullness.

A study from 2020 of 72 adults with obesity suggests that a weekly 2.4 milligram (mg) semaglutide injection over 20 weeks can help:

  • suppress appetite
  • improve control of eating
  • reduce food cravings

These factors were associated with a reduced body weight of 9.9% at the end of the study.

Another study from 2021 indicates that the same dosage of semaglutide over 68 weeks (17 months) helped participants lose closer to 15% of their body weight, or 35 pounds on average.

A note on dosage

The dosage used in these studies (2.4 mg) refers to semaglutide used for weight management (Wegovy) and not diabetes (Ozempic). Both are currently Food and Drug Administration (FDA) approved for adults with different indications for use.

Given the promising research, you might be hopeful that GLP-1 medications can help you with menopause-related weight gain.

A 2024 study suggests that this might be true when combined with menopausal hormone therapy (MHT).

This study included 106 postmenopausal women with obesity — 90 were only on semaglutide and 16 were on both MHT and semaglutide.

After 12 months of treatment, compared with those on semaglutide alone, women who were taking both MHT and semaglutide:

  • showed an improved weight loss response
  • achieved about 30% more total body weight loss

The reasons for this association are unknown, though the authors propose that it may be due to MHT improving other quality of life measures.

For example, if MHT helps relieve night sweats, and you get better sleep as a result, you might have more energy for exercise.

Speak with your doctor about using GLP-1 medications for menopausal weight gain. Based on your health profile, they may decide that they’re appropriate if the benefits outweigh the risks.

Those who may not be a good candidate for GLP-1 medication use include people with:

If you’re in perimenopause, pregnancy is still possible, and doctors advise against using semaglutide during pregnancy. You may also want to consider using birth control.

Watch out for these common side effects of semaglutide

Talk with your doctor if you experience any of the side effects listed below:

While common, they can lead to more serious health complications if left without proper treatment. Your doctor may need to adjust your dosage.

MHT has its own risks and benefits. Learn more about who should avoid it.

If you’re interested in taking semaglutide or MHT for your symptoms, several modes of administration are available:

However, keep in mind that not all forms of semaglutide have been FDA approved for weight loss. This includes oral semaglutide (Rybelsus).

Discuss with your doctor the right form, dosage, and formulation for you. It may take more than one try to find the best fit for your weight goals.

Be wary of compounded versions

While the FDA has approved several forms of semaglutide, it does not approve compounded versions. These may have more adverse side effects and additional risks.

Recent research is exploring using GLP-1 medications, such as semaglutide, to aid in weight loss during menopause. Early results are promising, especially if it’s combined with HT.

However, GLP-1 medications and MHT may not be suitable for certain people, and not all GLP-1 medications are FDA approved for weight loss.

Talking with your doctor can help you better assess your risk profile and whether this treatment can help you meet your weight goals.

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