Weight loss drugs could help treat PCOS

For well over a decade, Grace Hamilton, 27, experienced hair loss, heavy periods, infrequent menstrual cycles, mental health issues and difficulty losing weight without knowing why. It wasn’t until 2021 when she was diagnosed with polycystic ovary syndrome, or PCOS, a hormonal disorder common among women of reproductive age.

After she saw limited improvements from birth control, diet and exercise, Hamilton joined a trial in 2024 examining a GLP-1 drug in PCOS patients. By October, she received her first weekly dose of semaglutide, the active ingredient in Novo Nordisk‘s obesity injection Wegovy and diabetes shot Ozempic.

She said some results were almost immediate: after months without a cycle, her period resumed within two weeks of starting the drug. After 10 months on the treatment, Hamilton lost 50 pounds, saw hair regrowth and reported significant improvements in depression and anxiety

“I’m so glad that I stuck with it because it was just clear as day that it was the missing link for me,” said Hamilton, who works at a nonprofit in Arvada, Colorado, adding that she maintained diet and exercise while on the drug. 

She is just one of several women who have reported improvements in symptoms of PCOS after using GLP-1s, a growing class of obesity and diabetes treatments that have drawn massive patient demand and investor buzz over the last few years. Treating PCOS is among several new but unapproved potential uses of the blockbuster drugs beyond promoting weight loss and regulating blood sugar.

PCOS, which is frequently underdiagnosed, affects an estimated 5 million to 6 million women of reproductive age in the U.S., according to some estimates. 

The condition is typically characterized by higher levels of testosterone and other hormones usually associated with men called androgens, which can leads to symptoms such as irregular and painful periods, excess hair growth and acne. PCOS is the most common cause of infertility. 

The condition is strongly linked to metabolic issues, as an estimated 35% to 80% of patients experience insulin resistance. That means the pancreas pumps out more insulin to keep blood sugar in check, and high insulin levels can promote weight gain and disrupt hormone balance. A significant share of women with PCOS have obesity or Type 2 diabetes. 

Yet there’s no standard PCOS treatment. Current options like birth control, lifestyle changes and the diabetes drug Metformin may only help with certain symptoms, which could differ depending on the patient. 

But some health experts see promise in GLP-1s, particularly given their effect on improving weight loss and insulin sensitivity. 

“The unmet need is massive,” said Dr. Melanie Cree, a pediatric endocrinologist at Children’s Hospital Colorado. “Primary therapies used for PCOS symptoms haven’t changed in nearly 50 years.”

Cree has been studying the effect of GLP-1s in adolescents with PCOS for more than 10 years. She previously studied the oral form of semaglutide and has an ongoing clinical trial on the injectable version, which is what Hamilton participated in for 10 months. 

But her studies are still small in comparison to drugmakers’ previous clinical trials on GLP-1s with thousands of patients. Not all of the women who have so far completed Cree’s ongoing study lost significant weight, demonstrating that not everyone may respond to GLP-1s.

Novo Nordisk and rival Eli Lilly have been studying their GLP-1s as potential treatments for other chronic conditions like fatty liver disease, but not PCOS. Cree said that’s because the Food and Drug Administration has not established specific “endpoints” or goals drugs must meet in clinical trials to demonstrate how effective they are for PCOS. 

In a statement, a Novo Nordisk spokesperson said the company welcomes “independent research investigating the safety, efficacy and clinical utility of our products, including semaglutide.” Eli Lilly did not immediately respond to a request for comment. 

Conducting longer and larger trials to better understand the effect of GLP-1s on PCOS symptoms is crucial, said Sasha Ottey, executive director of the advocacy group PCOS Challenge. It is still unclear if GLP-1s can help address or resolve all PCOS symptoms, or whether the effect differs depending on a patient’s age or the specific drug, Ottey said. 

She added that certain patients may not lose weight on GLP-1s, and others may not need to shed pounds.

Meanwhile, insurance coverage for GLP-1s is a barrier for some PCOS patients, who are often eligible for approved uses of the drugs. Most plans cover…