Endocrinology and Metabolism Clinics of North America · Sep 7, 2026

GLP-1 Receptor Agonists and Reproductive Health: Implications for Contraception, Fertility, and Pregnancy

By Porterfield F, Mulligan J, Salim K et al.

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.

doi.org/10.1016/j.ecl.2026.07.003PubMed 42907053Interventions