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GLP-1s (like semaglutide and tirzepatide) are a class of medication that help regulate blood sugar, reduce appetite, and improve insulin sensitivity.^1-3 Insulin resistance is a key player in PMOS and is linked to several of the symptoms that patients experience including irregular cycles, weight gain, acne and excess hair growth.⁴ For many patients, treatment with GLP-1s can be a crucial component of their plan.

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If you've been navigating PMOS for any length of time, you already know the frustration: random periods, stubborn weight, acne that shows up at the worst time, fatigue, and generic advice that often boils down to "lose some weight" without any real or concrete advice. GLP-1 medications are now entering the chat because of how they target insulin resistance, the main culprit.

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Here's what they are, how they may help with your PMOS, and what to know before considering them.

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What Is a GLP-1?

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GLP-1 stands for glucagon-like peptide-1, a natural hormone your gut releases after eating. (For more information, check out our in-depth post on GLP-1s). It signals your pancreas to release insulin, slows down digestion, and tells your brain you're full.^1-3,5 GLP-1 medications (brand names like Ozempic, Wegovy, Mounjaro, and Zepbound) mimic this hormone at higher and more sustained levels than your body typically produces on its own.

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Originally developed to treat type 2 diabetes, these medications were later approved for weight management, and new research is suggesting that they may have many more benefits beyond weight loss and blood sugar management.^6-12

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How Do GLP-1s Help With PMOS?

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The majority of women with PMOS have some degree of insulin resistance, regardless of body weight.^11,12 Insulin resistance can affect between 65-70% of women with PMOS, including 20-25% of women with “lean” PMOS.¹² As we’ve talked about previously, insulin resistance is one of the main drivers of excess androgen production. Androgens are male hormones (like testosterone) that can interfere with your menstrual cycle.

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With insulin resistance, your cells become less responsive to insulin which causes sugars to linger in your blood stream. In turn, the pancreas continues to produce more insulin to help clear out the blood sugar. This excess insulin triggers your ovaries to produce more androgens.

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When insulin levels stay chronically elevated, androgen production can increase, which contributes to symptoms such as irregular or absent periods, acne, excess hair growth, and difficulty losing weight.^11,12 By improving how the body responds to insulin, GLP-1s may help interrupt this cycle at the source as well as support weight loss.

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What Benefits Have Been Linked to GLP-1 Use in PMOS?

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Early research and clinical use suggest GLP-1s may support more regular menstrual cycles, improved insulin sensitivity, modest reductions in androgen levels, and weight management though results vary by individual and more PMOS-specific research is still emerging.¹³‍

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Improved insulin sensitivity This is the primary mechanism, and the one most directly relevant to PMOS. Better insulin sensitivity can mean fewer blood sugar swings and, over time, may help regulate the hormonal cascade that drives PMOS symptoms.^11-13

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More regular cycles Because insulin resistance is linked to irregular ovulation, improving it may help restore more predictable menstrual cycles for some women.^13,14

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Weight management support GLP-1s slow digestion and reduce appetite, which can support weight loss goals. This is often a component of PMOS management, particularly when excess weight is contributing to insulin resistance.

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Reduced androgen-related symptoms. As insulin levels stabilize, androgen production can decrease. Some women report improvements in acne and excess hair growth but more research is needed (as is the case for many conditions impacting women’s health).^13-15

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Are GLP-1s Right for Everyone With PMOS?

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Just like any other medication GLP-1s are prescription medications with contraindications, side effects, and considerations that depend on your individual health history, and they aren't a first-line or standalone treatment for PMOS.

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Before considering a GLP-1, it's worth understanding a few things:

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1. They require a prescription and medical supervision. Your health care provider needs to evaluate whether a GLP-1 is appropriate for your health history, including any digestive, thyroid, or pancreatic conditions.
2. Side effects are common, especially early on. Nausea, digestive changes, and appetite suppression are typical as your body adjusts. They can often be alleviated by making strategic dietary adjustments.
3. They work best paired with nutrition support. Appetite suppression without adequate nutrient intake can lead to muscle loss or nutrient gaps. Working with a dietitian who is experienced in guiding patients using GLP-1s can help minimize the risk of nutritional deficiencies and unpleasant side effects.
4. They aren't a permanent fix on their own. Sustainable PMOS treatment typically combines medication (if appropriate), nutrition, movement, sleep, and stress management.
5. Cost and access vary widely. This can depend on your benefits plan and insurance coverage. It’s also worthwhile to read the fine print as some plans will terminate coverage after the patient achieves a certain BMI.

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How Should You Eat While Taking a GLP-1?

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Because GLP-1s significantly reduce appetite, getting enough protein, fibre, and micronutrients in smaller meals becomes a priority. Unfortunately, now that hunger signals have left the group chat, you can’t rely on your internal cues anymore. You need a targeted plan.

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When you're eating less overall, every bite needs to work harder nutritionally. This typically means:

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• Prioritizing protein at each meal to preserve muscle mass
• Including fibre-rich foods to support digestion, which tends to slow down under GLP-1s
• Staying on top of hydration, since reduced appetite often means reduced fluid intake too
• Watching for nutrient gaps that can develop when overall food volume drops

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Dietary shifts when starting a GLP-1 are hard to manage well without guidance. A dietitian who understands both PMOS and GLP-1s is basically non-negotiable.  

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How Can July Health Help You Navigate GLP-1s and PMOS?

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GLP-1s can be a genuinely useful tool for PMOS management, but they work best as part of a bigger picture, not a standalone fix. Figuring out how to eat enough of the right things while your appetite is suppressed, how to protect your muscle mass, and how to build habits that last beyond the medication is where most women get stuck.

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At July Health, our entire team is here to help support your goals.

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Nurse Practitioners can help you figure out if a GLP-1 is right for you. They’ll take the time to go through your history and symptoms without any of the weight bias or shaming you might have experienced up until now.

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Registered Dietitians know what’s up. We’re here to help you navigate your protein intake, troubleshoot any GI discomfort and can provide simple tricks to help alleviate some of the symptoms you might experience. We can provide personalized meal plans, product suggestions and easy swaps to make nutrition feel less scary.

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Registered Social Workers are our therapist allies. We know that it hasn’t been easy for you. PMOS impacts so much more than your physical health, it can leave a lasting emotional toll on your mental well being and self esteem.

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If you're navigating PMOS and want a nutrition plan that supports you as a whole person, book a session with a July Health dietitian to get started.

This article is for informational purposes only and isn't a substitute for individualized medical advice. Talk to your doctor before starting or stopping any medication.

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References:

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1. Meloni AR, DeYoung MB, Lowe C, Parkes DG. GLP-1 receptor activated insulin secretion from pancreatic β-cells: mechanism and glucose dependence. Diabetes Obes Metab. 2013 Jan;15(1):15-27. doi: 10.1111/j.1463-1326.2012.01663.x. Epub 2012 Aug 1. PMID: 22776039; PMCID: PMC3556522.

2. Larsson H, Holst JJ, Ahrén B. Glucagon-like peptide-1 reduces hepatic glucose production indirectly through insulin and glucagon in humans. Acta Physiol Scand. 1997 Aug;160(4):413-22. doi: 10.1046/j.1365-201X.1997.00161.x. PMID: 9338524.

3. Shankar A, Sharma A, Vinas A, Chilton RJ. GLP-1 receptor agonists and delayed gastric emptying: implications for invasive cardiac interventions and surgery. Cardiovasc Endocrinol Metab. 2024 Dec 4;14(1):e00321. doi:

4. Zeng X, Xie Y jie, Liu Y ting, Long S lian, Mo Z cheng. Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity. Clinica Chimica Acta. 2020;502:214-221. doi:10.1016/j.cca.2019.11.003‍

5. Cook G. Quieting "Food Noise": How GLP-1s and Mindfulness Rewire the Default Mode Network (DMN) and Reward Circuits. Cureus. 2026 Jan 5;18(1):e100818. doi: 10.7759/cureus.100818. PMID: 41502834; PMCID: PMC12770913.

6. Ferhatbegović L, Mršić D, Macić-Džanković A. The benefits of GLP1 receptors in cardiovascular diseases. Front Clin Diabetes Healthc. 2023 Dec 8;4:1293926. doi: 10.3389/fcdhc.2023.1293926. PMID: 38143794; PMCID: PMC10739421.

7. de Oliveira Almeida G, Nienkötter TF, Balieiro CCA, Pasqualotto E, Cintra JB, Carvalho HCP, Silva ALS, Kabariti JC, Minucci BS, Bertoli ED, Guida CM. Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials. Am J Cardiovasc Drugs. 2024 Jul;24(4):509-521. doi: 10.1007/s40256-024-00647-3. Epub 2024 May 11. PMID: 38734847.

8. Catanese B, Miller C, Wolf M, Edmonston D. Cardiovascular Outcomes among New Users of GLP-1 Receptor Agonists Compared with DPP-4 Inhibitors and Sulfonylureas in Kidney Failure. J Am Soc Nephrol. 2026 Mar 12:10.1681/ASN.0000001061. doi: 10.1681/ASN.0000001061. Epub ahead of print. PMID: 41817629; PMCID: PMC13240616.

9. Bade S, Hurdle MFB, Bade S, Encalada S, Kanahan-Osman S, Gupta S. GLP-1 agonists: a game changer in pain treatment and addiction. Pain Manag. 2025 Oct;15(10):753-765. doi: 10.1080/17581869.2025.2536998. Epub 2025 Jul 28. PMID: 40726115; PMCID: PMC12691565.

10. Gatto A, Liu K, Milan N, Wong S. The Effects of GLP-1 Agonists on Musculoskeletal Health and Orthopedic Care. Curr Rev Musculoskelet Med. 2025 Oct;18(10):469-480. doi: 10.1007/s12178-025-09978-3. Epub 2025 May 15. PMID: 40372699; PMCID: PMC12325148.

11. Amisi CA. Markers of insulin resistance in Polycystic ovary syndrome women: An update. World J Diabetes. 2022 Mar 15;13(3):129-149. doi: 10.4239/wjd.v13.i3.129. PMID: 35432749; PMCID: PMC8984569.

12. Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012 Jan;97(1):18-22. doi: 10.1016/j.fertnstert.2011.11.036. PMID: 22192137; PMCID: PMC3277302.

13. Hoteit BH, Kotaich J, Ftouni H, Hazime F, Safawi A, Masri R, Marwani M. The dual impact of GLP-1 receptor agonists on metabolic and reproductive health in polycystic ovary syndrome: insights from human and animal trials. Ther Adv Endocrinol Metab. 2025 Oct 7;16:20420188251383064. doi: 10.1177/20420188251383064. PMID: 41069706; PMCID: PMC12504844.

14. Voros C, Chatzinikolaou F, Papapanagiotou I, Polykalas S, Mavrogianni D, Koulakmanidis AM, Athanasiou D, Kanaka V, Bananis K, Athanasiou A, Athanasiou A, Papadimas G, Tsimpoukelis C, Vaitsis D, Karpouzos A, Daskalaki MA, Kanakas N, Theodora M, Thomakos N, Antsaklis P, Loutradis D, Daskalakis G. A Systematic Review on GLP-1 Receptor Agonists in Reproductive Health: Integrating IVF Data, Ovarian Physiology and Molecular Mechanisms. Int J Mol Sci. 2026 Jan 12;27(2):759. doi: 10.3390/ijms27020759. PMID: 41596408; PMCID: PMC12841515.

15. Almubaddil K, Alotaibi M, Bin Mutreb L, Alanazi F, Altulihee M. Effects of GLP-1 Receptor Agonists vs Metformin in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Cureus. 2026 Feb 19;18(2):e103927. doi: 10.7759/cureus.103927. PMID: 41873309; PMCID: PMC13006129.

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