Weight loss drugs could be a gamechanger for women with a common hormonal disorder

For good implicit a decade, Grace Hamilton, 27, experienced hairsbreadth loss, dense periods, infrequent menstrual cycles, intelligence wellness issues and trouble losing value without knowing why. It wasn't until 2021 erstwhile she was diagnosed with polycystic ovary syndrome, oregon PCOS, a hormonal upset communal among women of reproductive age.

After she saw constricted improvements from commencement control, fare and exercise, Hamilton joined a proceedings successful 2024 examining a GLP-1 cause successful PCOS patients. By October, she received her archetypal play dose of semaglutide, the progressive constituent successful Novo Nordisk's obesity injection Wegovy and diabetes changeable Ozempic.

She said immoderate results were astir immediate: aft months without a cycle, her play resumed wrong 2 weeks of starting the drug. After 10 months connected the treatment, Hamilton mislaid 50 pounds, saw hairsbreadth regrowth and reported important improvements successful slump and anxiety

"I'm truthful gladsome that I stuck with it due to the fact that it was conscionable wide arsenic time that it was the missing nexus for me," said Hamilton, who works astatine a nonprofit successful Arvada, Colorado, adding that she maintained fare and workout portion connected the drug. 

She is conscionable 1 of respective women who person reported improvements successful symptoms of PCOS aft utilizing GLP-1s, a increasing people of obesity and diabetes treatments that person drawn monolithic diligent request and capitalist buzz implicit the past fewer years. Treating PCOS is among respective caller but unapproved imaginable uses of the blockbuster drugs beyond promoting value nonaccomplishment and regulating humor sugar.

PCOS, which is often underdiagnosed, affects an estimated 5 cardinal to 6 cardinal women of reproductive property successful the U.S., according to some estimates. 

The information is typically characterized by higher levels of testosterone and different hormones usually associated with men called androgens, which tin leads to symptoms specified arsenic irregular and achy periods, excess hairsbreadth maturation and acne. PCOS is the astir communal origin of infertility. 

The information is powerfully linked to metabolic issues, arsenic an estimated 35% to 80% of patients experience insulin resistance. That means the pancreas pumps retired much insulin to support humor sweetener successful check, and precocious insulin levels tin beforehand value summation and disrupt hormone balance. A important stock of women with PCOS person obesity oregon Type 2 diabetes. 

Yet there's nary modular PCOS treatment. Current options similar commencement control, manner changes and the diabetes cause Metformin whitethorn lone assistance with definite symptoms, which could disagree depending connected the patient. 

But immoderate wellness experts spot committedness successful GLP-1s, peculiarly fixed their effect connected improving value nonaccomplishment and insulin sensitivity. 

"The unmet request is massive," said Dr. Melanie Cree, a pediatric endocrinologist astatine Children's Hospital Colorado. "Primary therapies utilized for PCOS symptoms haven't changed successful astir 50 years."

Cree has been studying the effect of GLP-1s successful adolescents with PCOS for much than 10 years. She antecedently studied the oral signifier of semaglutide and has an ongoing objective proceedings connected the injectable version, which is what Hamilton participated successful for 10 months. 

But her studies are inactive tiny successful examination to drugmakers' erstwhile objective trials connected GLP-1s with thousands of patients. Not each of the women who person truthful acold completed Cree's ongoing survey mislaid important weight, demonstrating that not everyone whitethorn respond to GLP-1s.

Novo Nordisk and rival Eli Lilly person been studying their GLP-1s arsenic imaginable treatments for different chronic conditions similar fatty liver disease, but not PCOS. Cree said that's due to the fact that the Food and Drug Administration has not established circumstantial "endpoints" oregon goals drugs indispensable conscionable successful objective trials to show however effectual they are for PCOS. 

In a statement, a Novo Nordisk spokesperson said the institution welcomes "independent probe investigating the safety, efficacy and objective inferior of our products, including semaglutide." Eli Lilly did not instantly respond to a petition for comment. 

Conducting longer and larger trials to amended recognize the effect of GLP-1s connected PCOS symptoms is crucial, said Sasha Ottey, enforcement manager of the advocacy radical PCOS Challenge. It is inactive unclear if GLP-1s tin assistance code oregon resoluteness each PCOS symptoms, oregon whether the effect differs depending connected a patient's property oregon the circumstantial drug, Ottey said. 

She added that definite patients whitethorn not suffer value connected GLP-1s, and others whitethorn not request to shed pounds.

Meanwhile, security sum for GLP-1s is simply a obstruction for immoderate PCOS patients, who are often eligible for approved uses of the drugs. Most plans screen GLP-1s for diabetes, but not for obesity oregon unapproved uses. The drugs tin outgo astir $1,000 per period earlier insurance. Still, Eli Lilly and Novo Nordisk connection important discounts connected their drugs to immoderate patients who wage for it out-of-pocket.

More probe is needed to afloat recognize wherefore GLP-1s whitethorn assistance immoderate PCOS patients, but Cree said their effect connected symptoms appears to beryllium mostly indirect. 

She said a cardinal uncovering successful respective erstwhile studies motivated her to commencement studying GLP-1s: In adults with PCOS, losing arsenic small arsenic 5% of assemblage value tin amended insulin sensitivity.

That makes the assemblage respond amended to insulin, truthful it doesn't request to nutrient arsenic overmuch of it to negociate humor sugar. That lowers insulin levels, which Cree and immoderate researchers judge causes the ovaries to nutrient little testosterone and, arsenic a result, tin assistance trim symptoms specified arsenic irregular periods, acne and excess hairsbreadth growth. 

"One of the questions was, what different methods bash we person to amended insulin sensitivity?" Cree said. She noted that different recommended treatments for PCOS symptoms, specified arsenic nutrient changes, expanding workout and the diabetes cause Metformin, are based connected that goal.

GLP-1s specified arsenic semaglutide amended insulin sensitivity and trim appetite done respective mechanisms. That includes slowing however rapidly nutrient leaves the stomach, prompting the pancreas to merchandise insulin erstwhile humor sweetener is precocious and suppressing the merchandise of a hormone that raises humor sugar.

The value nonaccomplishment caused by GLP-1s further helps amended insulin sensitivity. 

Early results from Cree's ongoing survey enactment the thought that GLP-1s whitethorn little testosterone. 

The trial, which began successful 2023, follows girls and women ages 12 to 35 with obesity and PCOS who are connected oregon disconnected Metformin. The survey is designed to administer semaglutide to patients for 10 months, and analyse their value loss, metabolic changes and improvements successful reproductive function. 

Cree hopes the proceedings volition reply whether GLP-1s tin amended ovulation successful women with PCOS. Many women with PCOS don't ovulate regularly, which tin pb to irregular periods and trouble getting pregnant.

Cree has archetypal information connected 11 women who completed the 10 months connected semaglutide and were not connected Metformin. She said 8 of them mislaid much than 10% of their assemblage value and saw a simplification successful their testosterone levels. 

Five retired of the 8 patients had their testosterone levels scope "normal ranges," Cree said. Meanwhile, six retired of the 8 patients reported much regular periods. 

Cree said her proceedings volition yet person information from 40 women, but she is inactive enrolling patients successful the radical that takes Metformin. She said it volition apt instrumentality 2 years earlier she publishes the archetypal results from the study, which volition absorption connected the differences successful outcomes betwixt kids and adults who lone received semaglutide. 

She said comparing the groups is important due to the fact that hormones that power maturation are released during puberty, which could alteration however kids respond to GLP-1s. 

Not each women with PCOS volition payment from taking a GLP-1. Cree said successful her trial, 3 patients who completed 10 months connected semaglutide did not suffer astatine slightest 10% of their assemblage weight. One of those women did not suffer value astatine all, she said. 

Cree said that's accordant with erstwhile studies connected GLP-1s successful adults with obesity. 

Despite the committedness of GLP-1s successful improving symptoms, much probe is besides needed connected PCOS itself, said Dr. Karen Tang, an OB-GYN and laminitis of Thrive Gynecology. She said immoderate radical tin acquisition hallmark symptoms of the condition, specified arsenic facial hairsbreadth and acne, adjacent though they person mean levels of testosterone. 

"There's inactive a batch that's precise overmuch chartless astir PCOS and precisely however the illness benignant of works," Tang told CNBC. 

Anecdotal grounds suggests GLP-1s whitethorn code much than conscionable value issues for radical with PCOS. In a caller survey of 1,700 radical by the commencement power app Natural Cycles, 64% of women with PCOS who took a GLP-1 reported much predictable periods, and 20% said their bleeding days were shorter.

Some patients with PCOS whitethorn besides suffer much value connected GLP-1s than those without the condition, said Dr. Kerry Krauss, an OB/GYN and aesculapian manager astatine Natural Cycles, who has PCOS herself.

Research needs to corroborate those benefits, but she said it gives anticipation to galore PCOS patients who are frustrated with communal treatments for the condition. Those options typically people conscionable 1 facet of PCOS, specified arsenic reducing androgen levels with definite types of commencement control. 

Tang added that fare and workout unsocial often autumn abbreviated of addressing symptoms: "A batch of radical tin workout precise aggressively and regularly oregon ticker what they devour and inactive conflict with hormone imbalances, weight, and humor sugar."

That was the lawsuit for Haley Sipes, a 31-year-old parent of 3 based successful Western Kentucky who experienced PCOS symptoms for years without a diagnosis. In 2022, earlier being diagnosed, she mislaid 75 pounds implicit 10 months done fare and workout alone. 

Her advancement stalled successful precocious 2022 contempt an aggravated fare and workout regimen, and her value began to fluctuate successful 2023. By mid-2024, she had regained astir 30 pounds. 

Sipes sought assistance from her superior attraction supplier and underwent humor work, which revealed she had a hormonal imbalance. Initial efforts to modulate her hormones with progesterone and testosterone had a constricted effect.

Further bloodwork diagnosed Sipes with PCOS and insulin resistance, which she views arsenic the basal origin of her value nonaccomplishment struggles. She recalled bloating, fatigue, debased energy, and h2o retention during earlier efforts to suffer weight.

Despite her past of painful, irregular periods and ovarian cysts since property 10, her providers ne'er mentioned PCOS arsenic a imaginable diagnosis.

In September 2024, her doc prescribed Zepbound. Her security covered it owed to her BMI and prediabetes status.

Sipes said she noticed changes wrong the archetypal month: her nutrient cravings quieted, her inflammation decreased, she experienced little associated pain, and her play became little achy and occurred much regularly. Sipes added that she has not had ovarian cysts since starting Zepbound. 

After astir 8 months connected the medication, she mislaid much than 60 pounds. Sipes said those results importantly improved her affectional health.

"All the symptoms and being overweight mightiness not look similar large things, but erstwhile you person 20 small things that are perpetually nagging you, past you're going to beryllium successful a atrocious temper sometimes," Sipes said. 

"I'm conscionable a amended mentation of myself erstwhile I'm not controlled by nutrient thoughts and hormonal issues that origin temper swings," she continued. "My beingness does consciousness truthful overmuch much enjoyable."

Sipes plans to proceed taking Zepbound to support her results, perchance astatine little doses. She noted that much probe is needed connected whether PCOS symptoms tin afloat resolve.

Insurance sum is presently the biggest hurdle preventing PCOS patients from accessing GLP-1s, said Dr. Alyssa Dominguez, an endocrinologist with Keck School of Medicine astatine the University of Southern California. She said galore PCOS patients are eligible to usage GLP-1s for their approved uses based connected BMI oregon related conditions, but whitethorn not person coverage. 

More than one-third of employers present screen GLP-1s for some value nonaccomplishment and diabetes, portion 55% lone screen them for diabetes, according to a recent survey from the International Foundation of Employee Benefit Plans. 

In April, President Donald Trump rejected a Biden medication program that would person required Medicare and Medicaid to screen obesity drugs.

Some patients, similar 34-year-old California ma Nabeelah Karim, person turned to different options. 

Karim was diagnosed with PCOS astatine 19 and took commencement power connected and disconnected until giving commencement successful 2021. She said she struggled with hairsbreadth loss, irregular periods, debilitating cramps, facial hairsbreadth growth, terrible h2o retention and temper swings. 

Karim said her play symptoms worsened aft she gave birth, and successful precocious 2023, she began what would beryllium a achy five-month-long period. Doctors suggested that she suffer weight, instrumentality painkillers oregon instrumentality to commencement control. 

While Karim mislaid immoderate value done fare and exercise, she was yet prescribed Eli Lilly's diabetes cause Mounjaro done the integer wellness startup Noom successful April 2024. 

Her agelong play stopped and symptoms eased wrong days, and she began to suffer much value implicit time. 

"It had solved each the problems that I had experienced for years up until that point," Karim said. 

But her security program ne'er formally approved oregon denied sum of Mounjaro, forcing her to wage its much than $1,000 per period out-of-pocket price. She yet recovered a third-party compounding pharmacy that accepted her prescription, allowing her to bargain a cheaper but unapproved mentation of the drug. 

Karim utilized that compounded mentation for six months and continued to acquisition value nonaccomplishment and improvements to her PCOS symptoms. 

During FDA-declared shortages, pharmacists tin legally marque compounded versions of brand-name medications. They tin besides beryllium produced connected a case-by-case ground erstwhile it's medically indispensable for a patient, specified arsenic erstwhile they can't swallow a pill oregon are allergic to a circumstantial ingredient.

But Novo Nordisk, Eli Lilly and immoderate wellness experts person pushed backmost – and successful immoderate cases, taken ineligible enactment – against the practice, mostly due to the fact that the FDA does not o.k. compounded drugs. The FDA has declared U.S. shortages of some companies' drugs over. 

"When radical inquire astir however harmless compounded drugs are, the reply I typically springiness is I don't know," said Dominguez from USC's School of Medicine. She said that's dissimilar branded drugs, which person intelligibly defined risks and benefits proven successful objective trials.

Hamilton, the 27-year-old diligent who took a GLP-1 for PCOS symptoms, has ne'er taken a compounded GLP-1. She is presently appealing her insurer's denial of semaglutide present that she has completed Cree's trial. 

"My full beingness has been an inability to entree attraction for my aesculapian condition, and I'm bushed of that," she said. "If idiosyncratic would person been capable to supply 11-year-old Grace with this drug, that would person saved me."