Ozempic and similar licensed weight loss drugs have exploded in popularity in recent years, with polls showing that as many as one in eight American adults have tried this class of medication at some point. However, while common side effects, like nausea and cramping, are well understood, many of the wider impacts of these drugs are overlooked, especially when it comes to our genitals.
Ozempic is an injectable prescription drug developed to manage blood sugar levels in patients with Type 2 diabetes. The drug has risen to recognition thanks to one side effect: weight loss.
The drug is based on a molecule called semaglutide, which mimics the structure of a hormone that naturally occurs in our bodies called glucagon-like peptide 1 (GLP-1). These hormones play an important role in regulating appetite and blood sugar levels by activating specific receptors involved in these pathways.
By mimic GLP-1's structure, semaglutide can also activate these receptors, inducing feelings of fullness while delaying the emptying of our stomachs. In other words, it makes us less hungry and, therefore, less likely to overeat.
Semaglutide is also used in Ozempic's sister drug, Wegovy, which has been approved by the FDA for chronic weight management. But while these drugs have helped millions of Americans move closer to their weight loss goals, they can be accompanied by some unpleasant -- and often unexpected -- side effects.
"GLP-1 receptor agonists such as Ozempic have become increasingly popular for weight loss and diabetes management," Dr. Melanie Bone, a consultant OBGYN and U.S. medical director at the gynecological health company Daye, told Newsweek. "However, their effects on vaginal health are an important consideration that is often overlooked."
But how does a drug that targets your stomach affect your genitals? "These medications can potentially impact vaginal health in several unexpected ways," Bone said. "Firstly, the rapid weight loss induced by GLP-1 agonists may alter hormone levels, which could affect vaginal lubrication and tissue health. Some women may experience increased vaginal dryness as a result.
"Additionally, GLP-1 agonists can cause gastrointestinal side effects like nausea, vomiting, and diarrhoea. These symptoms may lead to dehydration, which could further contribute to vaginal dryness and discomfort. The changes in diet and gut microbiome associated with these medications may also indirectly impact the vaginal microbiome due to the gut-vagina axis."
Beyond this, some reports have suggested that Ozempic and other GLP-1-based drugs may impact fertility, with numerous anecdotal cases of women getting pregnant on Ozempic despite using birth control. As with effects on vaginal dryness, doctors believe that these so-called "Ozempic babies" may result from the drug's direct interference with the absorption of oral contraceptives. The subsequent weight loss seen by many on these drugs may also contribute to increased fertility.
"To maintain vaginal health while using GLP-1 agonists, I recommend staying well-hydrated, using a vaginal probiotic and considering the use of vaginal moisturizers if experiencing dryness," Bone said. "It's also important to pay attention to any changes in vaginal discharge or odour, as these could indicate an alteration in the vaginal microbiome and potential vaginal infections."
She added that regular screenings of vaginal health are also advisable. "By checking on their vaginal health regularly, patients can monitor for any changes in their vaginal microbiome that may be associated with GLP-1 agonist use," Bone said. "This proactive approach allows for early detection and management of any issues that may arise."
She continued: "It's crucial for women and assigned female at birth (AFAB) individuals to discuss any vaginal health concerns with their healthcare provider while using GLP-1 agonists. Open communication about these potential effects can lead to better management and overall health outcomes."