GLP-1s & Menopause: What You Should Know

For many women, menopause can bring frustrating changes. Weight gain, shifts in metabolism, increased cardiovascular risk, and changes in body composition are all common during this stage of life. Even women who have maintained healthy habits for years may find that the strategies that once worked no longer seem effective.

At the same time, GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound have become increasingly popular for weight management and metabolic health. As more women in midlife begin exploring these medications, it is important to understand how they work, their ability to address some of the challenges associated with menopause, and finally some of the risks associated with their use.

What Are GLP-1s and How Do They Work?

GLP-1 agonists are medications originally developed to treat Type 2 diabetes (Collins & Costello, 2024). They work by mimicking hormones in the body that regulate blood sugar, insulin production, digestion, and appetite.

These medications help increase insulin secretion after eating, slow gastric emptying, and increase feelings of fullness, which can reduce food intake and improve blood sugar regulation (Collins & Costello, 2024).

Research has also shown that GLP-1s may support weight loss while improving blood pressure, cholesterol, and cardiovascular health markers. Additional studies suggest they may improve glucose uptake in muscles, reduce glucose production in the liver, and increase satiety through effects on the brain.

Because menopause is often associated with increased abdominal fat, insulin resistance, and elevated cardiovascular risk, researchers are increasingly interested in how GLP-1s may support women during midlife.

Can GLP-1s Help Women in Menopause?

Weight gain and increased cardiovascular risk are both common and difficult-to-manage symptoms of menopause (Castanada et al., 2026). Hormonal changes during perimenopause and menopause can make weight management more challenging, even for women who maintain healthy lifestyles.

Emerging research suggests menopausal hormone therapy (MHT) may improve outcomes for some women taking GLP-1 medications. A recent Mayo Clinic study found that postmenopausal women using hormone therapy lost significantly more weight while taking tirzepatide compared to women not using hormone therapy (Castanada et al., 2026).

Researchers reviewed data from 120 participants with overweight or obesity who used tirzepatide for at least 12 months, suggesting hormonal status may influence how women respond to GLP-1 medications during menopause.

For some women, GLP-1s may help improve:

• Weight management

• Appetite regulation

• Insulin resistance

• Cardiovascular risk factors

• Overall metabolic health

However, experts emphasize that these medications work best alongside strength training, adequate protein intake, sleep, stress management, and regular exercise.

What Are the Risks?

Despite the growing popularity of GLP-1s among women in midlife, there are still many unanswered questions about their long-term effects in perimenopausal and menopausal women.

Recent data suggests GLP-1 use is especially high among women in these age groups, despite limited research focused specifically on their hormonal and metabolic needs (Rancaño & Donofry, 2025).

Researchers are also concerned about what happens when women stop taking these medications. Studies show GLP-1s reduce both fat mass and muscle mass, and discontinuing treatment often results in weight regain, primarily as fat mass. This is particularly important during menopause, when women are already experiencing natural declines in muscle mass and bone density (Rancaño & Donofry, 2025).

Long-term adherence may also be difficult. Research shows more than half of patients discontinue GLP-1 use within one year, and many regain a significant portion of the lost weight after stopping treatment (Rancaño & Donofry, 2025).

Side Effects and Bone Health

While effective for weight loss and metabolic health improvement during use, GLP-1s have some common side effects. The most common side effects of GLP-1 medications include nausea, vomiting, diarrhea, dizziness, headaches, digestive discomfort, and injection-site irritation (Collins & Costello, 2024).

An emerging concern of GLP-1 use for women in menopause is bone health. Some preliminary studies suggest they may contribute to reductions in bone mineral density, although more research is needed to fully understand this relationship (Karam et al., 2025). At a time when bone density loss is already common, this associated risk is important to consider and understand before taking GLP-1 medications.

Because menopausal women already face increased risk of osteoporosis, experts increasingly emphasize the importance of resistance training, adequate protein intake, and monitoring muscle and bone health while using these medications.

The Bottom Line

GLP-1 medications are changing the conversation around weight management and metabolic health, especially for women navigating perimenopause and menopause.

For some women, these medications may offer meaningful support for weight loss, insulin resistance, appetite regulation, and cardiovascular health. However, there are still important unanswered questions about their long-term effects on muscle mass, bone density, and healthy aging in midlife women.

As research continues to evolve, experts agree that GLP-1 medications work best as part of a comprehensive approach to menopause health, with a focus on nutrition, movement, and stress management.

Sources:

Castaneda, R., Bechenati, D., & Tama, E. (2026). The role of menopause hormone therapy in modulating tirzepatide-associated weight loss in postmenopausal women with overweight or obesity: a retrospective cohort study. The Lancet Obstetrics, Gynaecology, & Women’s Health, 2, e118-e128. https://www.thelancet.com/journals/lanogw/article/PIIS3050-5038(25)00145-1/abstract

Collins, L., & Costello, R. A. (2024). Glucagon-Like Peptide-1 receptor agonists. In StatPearls. StatPearls Publishing.

Karam, L., Mabilleau, G., & Paccou, J. (2025). Effects of Glucagon-Like Peptide-1 receptor agonists on bone health in people living with obesity. Osteoporosis International, 36(11), 2115–2126. https://doi.org/10.1007/s00198-025-07664-1

Rancaño, K. M., & Donofry, S. D. (2025, August 6). GLP-1 agonists in perimenopause: Unique risks and potential opportunities. Rand.org; RAND Corporation. https://www.rand.org/pubs/commentary/2025/08/glp-1-agonists-in-perimenopause-unique-risks-and-potential.html

DRA: 1180051226