Dr. Ahmed Ozempic (and other brands of Semaglutide, Rybelsus, and Wegovy) is one of the new medications, doctors think will help women with hormonal disturbances.
The direct effects of Ozempic on the menstrual cycle have not been evaluated so far. Changes in the menstrual cycle have a great psychological impact on women.
Therefore, we collected data from women who shared their personal experiences to evaluate the effects of Ozempic on the menstrual cycle.
The effects of Ozempic on the Menstrual Cycle (Periods):
A total of 36 women shared their experiences while they were using Semaglutide.
Most women were using Ozempic (64%). Some of them did not mention the brand, however, they were likely using Ozempic or Wegovy.
The average duration of treatment using Semaglutide was 8 weeks (the minimum duration of treatment was one week and the maximum duration of treatment was 28 weeks).
Among women who were using Ozempic or Wegovy, more than half of them were on 0.25 mg per week.
Two women were on 1.7 mg per week. Two women in the Rybelsus group were using 7 mg tablets daily.
About 10% of the women had concomitant PCOS (polycystic ovarian syndrome).
Change in the Menstrual cycle | Percentage of women |
| Increased duration of the menstrual cycle | 51.7% |
| Decreased duration of the menstrual cycle | 24.1% |
| No change noticed | 17.2% |
| Better and Timely Periods | 6.9% |
Painful menstruation (period cramps) was reported by 25 percent of women. Those who did not experience any change in menstrual cycles and those who reported better and timely cycles had no pain during menses.
“Painful cycles and period cramps” was reported by most women who noticed a change in their cycles, particularly those who had prolonged periods.
| Change in the Menstruation | Percentage of women who reported pain and cramps |
| Increased duration of the menstrual cycle | 16.66% |
| Decreased duration of the menstrual cycle | 8.33% |
| No change noticed | 0 |
| Better and Timely | 0 |
Most women who reported an increase in the duration of menses had more than 7 days of bleeding.
Those who reported decreased menstruation either reported scanty flow or had a duration of menstrual cycles lasting less than their usual cycles.
Ozempic and Periods: Reviews and comments by patients:
Reviews and comments of patients who observed changes in their menstrual cycles are posted here below.
Patients who reported “better and timely” menstrual cycles with Semaglutide:
Only a few people described their menstrual cycles as more timely and better than before. People who reported timely menstrual cycles commented:
| I am 56 years old and on my fifth dose. I haven’t had a period in 10 months and I just got one. Happy about the weight loss I’ve had, which is a total of 6 lbs but this is a huge surprise. |
| Menstrual cycle bleeding at 56 years of age is surprising in this patient. She needs to be observed for other gynecological issues as well. She might be in the peri-menopausal period. It’s the time when women stop bleeding. |
| “I was diagnosed with PCOS years ago, and have gained about 60 lbs. I couldn’t lose any weight from dieting and exercising and I just kept gaining weight”. My OB/Gyn endocrinologist didn’t want to put me on liraglutide because she didn’t feel comfortable with it. But my other endocrinologist prescribed me Wegovy, and I got lucky and am paying only $25/mo for six months. I’m eating the same things and exercising the same amount I did before starting Wegovy, and I’m losing weight! (I’m 5’4”)” |
This patient also talked about how she lost weight over a period of ten weeks. Her weight loss profile by week is mentioned here:
| Weeks of Treatment | Weight (lbs) |
| Baseline Weight | 169 |
| week 1 | 166 |
| week 2 | 165.1 |
| week 3 | 163.4 |
| week 4 | 161.4 |
| week 5 | 158.6 |
| week 6 | 159 |
| week 7 | 157.6 |
| week 8 | 156.6 |
| week 9 | 153.8 |
| week 10 | 153.2 |
This patient lost about 17 lbs of weight and had better and more timely menstrual cycles. Secondly, she had PCOS. This means she had issues with her periods in the past.
Ozempic and Wegovy, like their weight loss effects, are thought to affect the lifestyle of patients with PCOS significantly.
Patients who reported “Decreased and Painful” menstrual cycles with Semaglutide (Ozempic and Period Cramps):
Very few women reported that their menstrual cycles decreased compared to before using Ozempic. Women’s comments about their menstrual cycle are presented here:
| “Sooo my first period on wegovy was really short. The last few have been heavy BUT I also had Covid. Sooo I’m not a good test case. Hahahah Also not on an BC because it makes me insane.” |
Another patient who was on Oral Semaglutide (Rybelsus Tablets) commented:
| “I was on 3mg for a month and now about 8 days into 7mg. My first cycle on it seemed normal but now this cycle 5 days late and no sign of her coming!” |
Two other patients noticed that there cycles reduced compared to the months before using Semaglutide:
| “I have had less period, barely anything, I wonder is it down to the weight loss”. |
| “Yes, my cycle increased from 34 days (on metformin) to 37 days on ozempic. My cycles are non-existent without an insulin sensitizing agent”. |
A decreased menstrual cycle could be a result of multiple factors. One important factor that affects the duration and flow of menstrual cycles in women using Ozempic(or any Semaglutide) is the change in weight.
Weight can have direct and indirect effects on the menstrual cycle. How Ozempic affects female menstrual cycles is discussed at the end of the article.
People who reported “heavy and painful menstrual bleeding”: Heavy Periods with Cramps
Heavy and painful menstrual bleeding was commonly observed in patients using Ozempic or other Semaglutide formulations.
People who had heavy and painful menstrual cycles reported as:
| “I have been on Ozempic for about a month and a half with about 2 weeks off. I have noticed when I take the Ozempic, I bleed non-stop. Sometimes spotty and dark and sometimes not. Does anyone else have this? I have noticed it kind of slows down when I don’t take Ozempic. My gynae doctor just suggested that I double up on birth control to make it stop but that only worked well when I wasn’t on Ozempic. any tips?” |
Similarly, other patients also had a similar experience using Ozempic. This person reported his wife’s experience while on Ozempic:
| “My wife started having problems once she started using Ozempic, lasted so long that the same Dr recommended a procedure to stop the bleeding knowing that Ozempic is the cause and $20000 later she just started the same bleeding a few hours after her injection”. |
Few patients reported spotting despite using OCPs, and IUDs (Intrauterine devices). This patient had a contraceptive implant and still had menstrual bleeding:
| “I have a contraceptive implant and only very rarely get periods at all. After my second shot (0.25mg of Wegovy), I had the worst period I’ve had in years.” “Heavy bleeding, extremely painful cramps, lasted a week. After that, I returned to my normal not-having-periods self”. |
Similarly, this patient reported severe cramps during her menses.
| “I have had one period on Ozempic and it was shocking! Normal period 2 to 3 days this one lasted 7 to 8 horrible cramps just felt a whole lot different. I was hoping g Ozempic would stop cravings around period but nope still wanted chocolate and just sweets in general.” |
Another patient reported prolonged bleeding. It is important to check the hormonal profile and bleeding parameters in such patients:
| “Folks, who menstruate, have you noticed anything changing in your cycle? I have been bleeding for almost a month now. The doctor said it could be weight loss-related. Would also appreciate any tips to make my period stop haha”. |
This patient had heavy bleeding after a long time. It was ironic (as the patient described) since she got her period on the same day as the injection.
| “I gave myself the first shot of 0.25 on Monday… I haven’t had my period in months. I got it Monday night. Obviously could be ironic lol. My worst period in years too. Heavy bleeding for sure” |
Ozempic and Periods: Does Ozempic Affect Periods?
Ozempic has direct and indirect effects on female hormones. It is also been evaluated for the treatment of women with polycystic ovarian syndrome, however, studies have not been published yet.
Ozempic enhances insulin sensitivity and reduces abdominal and visceral fat. It also improves the symptoms of PCOS and may induce ovulation by its inhibitory effects on androgen synthesis.
Apart from its effects as an insulin-sensitizing agent, Ozempic also affects menstruation by improving androgen metabolism, enhancing ovulation, and reducing body fat.
Female hormonal changes have also been associated with changes in body weight.
Generally, obese women have less frequent and scanty menstrual cycles compared to women of normal weight.
On the other extreme, anorexic and markedly underweight women also menstruate less frequently.
Ozempic and especially Wegovy is associated with significant weight loss. Among all the weight loss medicines, Wegovy is considered superior. It is associated with up to 16% weight loss.
Ozempic reduces the activity of adipokines and 5-alpha-reductase inhibitor (the enzyme responsible for converting testosterone into its active form. Low levels of testosterone are associated with better and more timely menstrual cycles.
Reducing visceral fats and body fat distribution also has a favorable effect on female hormones and menstrual cycles.
In Summary:
Women on Ozempic (or other formulations of Semaglutide) usually observe changes in their menstrual cycles. Most women observed an increased flow and duration of menstrual cycles.
Painful menstrual cycles are also commonly reported. The change in menstrual cycles may be associated with mood disturbances that can affect the blood glucose and weight loss journey of obese women.
Studies are needed to address the effects of Ozempic on female menstrual cycles and hormonal profiles.
