Endocrinology and metabolism clinics of North AmericaOct 22, 2026

How GLP-1 Receptor Agonists May Affect Contraception, Fertility, and Pregnancy

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Oct 23, 2026

Abstract

GLP-1 receptor agonists (GLP-1 RAs) may improve insulin resistance and androgen profiles in women with polyendocrine metabolic ovarian syndrome (PMOS).

GLP-1 signaling is associated with potential effects on reproductive physiology via the hypothalamic-pituitary-ovarian axis.
Improvements in menstrual regularity have been observed in women with PMOS using GLP-1 RAs.
Most GLP-1 RAs do not significantly alter the effectiveness of oral contraceptives, though tirzepatide may necessitate temporary backup contraception.
Evidence regarding fertility outcomes and pregnancy safety with GLP-1 RAs is currently limited.

Simplified

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have rapidly expanded in use for the treatment of obesity and type 2 diabetes, including among women of reproductive age. Emerging evidence suggests that GLP-1 signaling may influence reproductive physiology through central effects on the hypothalamic-pituitary-ovarian axis and indirect metabolic pathways. In women with polyendocrine metabolic ovarian syndrome (PMOS), GLP-1 RAs improve insulin resistance and androgen profiles and may improve menstrual regularity. Most GLP-1 RAs do not significantly affect oral contraceptive pharmacokinetics, although tirzepatide may require temporary backup contraception. Evidence regarding fertility outcomes and pregnancy safety remains limited.

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How GLP-1 Receptor Agonists May Affect Contraception, Fertility, and Pregnancy

Abstract

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