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GLP-1 Receptor Agonists and Reproductive Health: Implications for Contraception, Fertility, and Pregnancy
Florence Porterfield1, Jennifer Mulligan2, Katherine Salim3
1Division of Endocrinology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Abstract:
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have rapidly expanded in use for the treatment of obesity and type 2 diabetes, including among women of reproductive age. Emerging evidence suggests that GLP-1 signaling may influence reproductive physiology through central effects on the hypothalamic-pituitary-ovarian axis and indirect metabolic pathways. In women with polyendocrine metabolic ovarian syndrome (PMOS), GLP-1 RAs improve insulin resistance and androgen profiles and may improve menstrual regularity. Most GLP-1 RAs do not significantly affect oral contraceptive pharmacokinetics, although tirzepatide may require temporary backup contraception. Evidence regarding fertility outcomes and pregnancy safety remains limited.
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