Increased utilization of GLP-1 among perimenopausal women outpaces research progression
In the realm of weight management, a growing number of perimenopausal women are turning to GLP-1 medications, such as Ozempic (semaglutide) and Zepbound (tirzepatide). These drugs, traditionally used for Type 2 diabetes, are proving to be effective for weight loss in perimenopausal and postmenopausal women, particularly when combined with menopause hormone therapy (MHT).
Research suggests that the combination of GLP-1 drugs and MHT enhances weight loss outcomes significantly compared to GLP-1 drugs alone. One study showed women using both tirzepatide and MHT lost 17% of their body weight, compared to 14% with tirzepatide alone, and nearly half achieved at least 20% body weight loss compared to less than one-fifth without hormone therapy.
However, it's important to note that while these medications show promise, they are not without risks. Common side effects include nausea and digestive symptoms. There is also emerging concern about potential risks for vision problems, though the evidence is inconsistent and further investigation is ongoing.
GLP-1 medications are typically prescribed as part of a comprehensive health and lifestyle approach, considering a woman’s overall metabolic health, risk factors, and motivation. Women with a history of certain cancers or pancreatic/parathyroid conditions are usually advised to avoid these drugs.
The intersection of GLP-1 use and perimenopause presents a prime opportunity for more inclusive, life-stage-specific research. Unfortunately, current studies largely exclude women in the age range of 30-49. This lack of targeted research could lead to poor clinical decisions, missed opportunities for care, and increased physical and mental health risks.
Experts warn that the absence of targeted research on GLP-1 medications in perimenopausal women could lead to poor clinical decisions, missed opportunities for care, and increased physical and mental health risks. The psychosocial impacts of GLP-1-induced weight loss, especially around body norms, stigma, and weight cycling, are largely unknown.
Moreover, the absence of targeted research could also impact the treatment of conditions that spike in prevalence during perimenopause, such as obstructive sleep apnea. GLP-1s are now FDA-approved for treating obstructive sleep apnea, but their effectiveness in addressing this surge in risk remains untested in women undergoing hormonal shifts.
Perimenopausal women, typically aged 45-55, are among the most common users of GLP-1 medications. Despite this, the average weight loss for users of GLP-1 medications ranges from 10% to 21%. However, regaining weight after GLP-1 use has been linked to shame, hopelessness, and even disordered eating. Discontinuation of GLP-1s often leads to rapid weight regain, primarily as fat, further compounding the risks for perimenopausal women.
GLP-1s reduce both fat and muscle mass, which could be problematic for women already experiencing natural declines in muscle and bone density during perimenopause. Perimenopause, a global phenomenon affecting more than 1.5 billion women, brings a complex mix of hormonal, metabolic, cardiovascular, and mental health changes. Without life-stage-specific research, doctors and patients are left to navigate treatment during one of the most biologically complex periods of a woman's life-with far too many unknowns.
A report from nonprofit research organization RAND cautions that the scientific community has largely overlooked how GLP-1 medications interact with the unique physiological and psychological changes occurring during perimenopause. As we continue to explore the potential of GLP-1 medications in perimenopausal women, it's crucial to prioritise research that addresses these gaps and provides clear, evidence-based guidance for both patients and healthcare providers.
- The combination of GLP-1 drugs and menopause hormone therapy (MHT) can significantly enhance weight loss outcomes, particularly for women suffering from chronic diseases like obstructive sleep apnea during perimenopause.
- As more women turn to GLP-1 medications for managing their weight during menopause, it is crucial to conduct research focused on women's health issues such as weight-management, medical-conditions, and psychosocial impacts specific to the perimenopausal period.
- RAND's report has highlighted the need for a greater emphasis on research into the interaction between GLP-1 medications and the unique physiological and psychological changes that occur during perimenopause, in order to provide evidence-based guidance for both patients and healthcare providers.
