Ozempic Users Need Better Contraception
Claims that “skinny jabs” are causing an unexpected baby boom have prompted experts to advise women to use effective contraception alongside these medications.
Drugs like Wegovy and Ozempic, which contain semaglutide, have gained immense popularity due to their ability to help users lose more than 10% of their body weight. These medications work by mimicking a hormone called GLP-1, increasing insulin production, slowing stomach digestion, and reducing appetite.
However, the rise in the use of these drugs has coincided with numerous reports of women becoming pregnant while using them—these drugs are known as GLP-1 receptor agonists. The Facebook group “I got pregnant on Ozempic” has over 750 members, and Reddit threads are filled with similar anecdotes.
Although studies confirming a direct link are lacking, experts believe the association is plausible. Dr. Karin Hammarberg of Monash University in Australia explains that women with obesity often have irregular or no periods due to anovulation. Weight loss can lead to more regular ovulation, thereby improving fertility.
Research is ongoing to investigate whether semaglutide can enhance ovulation in women with obesity and polycystic ovary syndrome (PCOS), a condition associated with irregular periods, weight gain, and infertility.
Despite potential benefits, concerns exist about the safety of using GLP-1 receptor agonists during pregnancy. A Novo Nordisk spokesperson, the manufacturer of Ozempic and Wegovy, noted that pregnancy or intention to become pregnant were exclusion criteria in their trials. Consequently, there is limited clinical trial data on semaglutide use in pregnant women.
Animal studies have indicated that semaglutide may cause fetal abnormalities. Novo Nordisk reported that pregnant rats exposed to the drug showed structural abnormalities and growth alterations in their offspring. Similar outcomes were observed in studies with rabbits and cynomolgus monkeys, with increased pregnancy loss and slight increases in fetal abnormalities at clinically relevant doses.
Novo Nordisk is conducting trials to determine the safety of these drugs for pregnant women. Meanwhile, the company advises against using semaglutide during pregnancy due to unknown effects on an unborn child. The patient information leaflet for Wegovy recommends using contraception while taking the medication and stopping its use at least two months before trying to conceive.
Despite these precautions, some women have reported pregnancies while using GLP-1 receptor agonists and hormonal contraception, sparking speculation that the drugs might interfere with birth control effectiveness.
Professor Sir Stephen O’Rahilly of the Wellcome-MRC Institute of Metabolic Science highlighted that the question of whether GLP-1 receptor agonists affect oral contraceptives remains largely unanswered. Gastrointestinal side effects like diarrhea from these drugs could potentially impair the absorption of oral contraceptives.
To mitigate the risk of unintended pregnancy, O’Rahilly suggests that women on the pill who wish to avoid pregnancy should consider using additional contraception, such as barrier methods, during active weight loss on GLP-1 receptor agonists. Once weight stabilizes, contraceptive efficacy is likely to return to normal.
Hammarberg supports this advice, noting that while anecdotal reports exist of women on semaglutide getting pregnant while on the pill, this can also happen without the medication. She advises that women on Ozempic and similar drugs use condoms or consider an IUD to ensure effective contraception.