GLP-1 Medications and Menopause: What You Need to Know by Dr Kari Nightingale

If you’ve found your weight creeping up during perimenopause or menopause, you’re not alone. Shifting hormones, a naturally slower metabolism, and changes in body composition all make it easier to gain weight—particularly around the middle—and harder to take it off. Many women feel frustrated when their healthy eating and exercise efforts don’t seem to match the results.

But weight isn’t just about appearance. Carrying excess weight can raise the risk of type 2 diabetes, high blood pressure, heart disease, joint pain, and sleep problems. It can also affect mood, energy levels, and overall quality of life. That’s why managing weight in midlife is really about supporting your health, not just your dress size.

In recent years, a new class of treatments—GLP-1 medications such as semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro)—have been called game-changers for weight management and metabolic health. While they’re not suitable for everyone, and their long-term impact is still being studied, many women are finding them helpful when prescribed and monitored appropriately by a doctor.

So, how do they work? GLP-1 stands for glucagon-like peptide-1, a natural hormone released after eating that tells the brain you’re full, slows digestion, and helps regulate blood sugar and fat use. Wegovy and Ozempic mimic this hormone, while Mounjaro also targets another one (GIP) for an added appetite-control effect. The result: smaller portions feel satisfying, cravings fade, and weight loss becomes more achievable.

On average, research shows Wegovy can support around 15% weight loss in a year, while Mounjaro may reach closer to 20%. Both can also improve blood sugar, cholesterol, and blood pressure—important for protecting heart health during and after menopause.

Like any medication, GLP-1 treatments come with possible side effects. The most common are nausea, constipation, diarrhoea, or vomiting, which usually settle as your body adjusts. Simple strategies—smaller meals, bland foods, hydration, and gentle activity—often help. More serious complications, like pancreatitis or gallbladder problems, are rare but require immediate medical attention.

If you’re taking HRT, contraception, or other medicines, there are some important interactions to consider. Because GLP-1s slow digestion, oral HRT and contraceptives may not absorb as predictably, and dosage adjustments might be needed. They can also affect how your body processes other medications such as those thyroid, epilepsy or heart medicines. Always review your full medication list with your doctor.

Planning a pregnancy? These drugs need to be stopped well in advance. And if you’re scheduled for surgery, it’s vital to let your consultant know, since delayed stomach emptying could pose risks under anaesthetic. It’s important to remember: GLP-1s are not quick fixes. They work best as part of a bigger lifestyle approach. Weight loss can include muscle as well as fat, which is why nutrition and movement are essential companions to treatment. Focus on balanced meals with protein, fibre, and healthy fats, while limiting alcohol, sugar, and processed foods. Cardiovascular activity (like walking, swimming, cycling) supports heart health, and strength training is key for protecting muscles and bones during weight loss and menopause. Many women find it easier to stay on track by exercising with a friend, joining a class, or using an online programme.

GLP-1 medications can be powerful tools, but they’re definitely not sutiable for everyone nor are they the only path to better health. Whether you choose to use them or not is a personal decision that should be guided by a detailed consultation with your doctor.

At the end of the day, your wellbeing is not defined by a number on the scales. The real goal is to feel strong, energised, healthy and confident in your body as you move through this new stage of life.

If you want to know more, I talk about these medications with my colleague in the reel below.

https://www.instagram.com/reel/DOyPdL7Ckwt/?igsh=MTh5NmpzNncyeHR2aA==

Dr Kari Nightingale

GP and British Menopause Society accredited menopause specialist. Accredited lifestyle medicine doctor.

https://www.menopausecare.co.uk/associate-dr-kari-nightingale