Chances are that by now you've heard of Ozempic, a brand name for semaglutide, one of a group of medications called GLP-1 receptor agonists. In its various guises, this type 2 diabetes medication has been making headlines in the last year for its off-label use as a weight-loss drug. Its appetite suppressant side effects mean it's swept Hollywood and beyond, contributing to dramatic weight loss – and a significant amount of controversy.
Recently, the injectable has been cropping up in the news again – but for a different reason: its potential effect on some forms of contraception. Various reports have suggested that the drug might make the contraceptive pill less effective.
'Ozempic babies! Women on birth control are getting pregnant after starting weight loss drugs', shouts one Daily Mail article published in March. Meanwhile, the 'I got pregnant on Ozempic' Facebook group has 577 members (at the time of writing) for 'support and shared experiences'. It's worth noting that if you access this private group, however, there are no users who report getting pregnant while taking both the pill and Ozempic. Most seem to be there to share the idea that medicated weight loss has increased their fertility, as well as to discuss the effect of Ozempic on pregnancy and a developing foetus.
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Over on TikTok, more women are reporting unexpected pregnancies while taking the controversial medication. 'Here is your PSA to everyone', says @dkalsolive in a video that's attracted over 735.4K views, in which she also claims that the medication 'lessens the effectiveness of your birth control'.
It's one of the many pieces of 'Ozempic pregnancy' content doing the rounds on the platform. And the comments sections are full of other women reporting an apparent increase in their fertility while using the drug. 'I never got naturally pregnant in 11 years of marriage... only did like 3 shots of semaglutide and boom. Out of nowhere. So shocked.'
So what's the truth behind the internet noise? Long story short: there isn't enough research into the subject for a definitive answer. But there is the fact that weight loss in itself can change the balance of hormones. 'Research is sparse on this, but we do know that being a healthy weight can be key for fertility, so weight reduction can improve chances of conception for some,' says Dr. Laura Falvey of Roczen.
But what about the pill? Back in 2015, a study published in the Journal of Clinical Pharmacology stated that oral contraceptive medication is thought to rely on a different 'metabolic pathway' to semaglutide and other GLP-1 receptor agonists – in other words, the two are thought to be broken down in different ways.
Concerns remain that the medication can delay the absorption of the contraceptive pill though. 'GLP-1 receptor agonists such as Ozempic (semaglutide) and Mounjaro (tirzepatide) work, in part, by delaying gastric emptying – the rate at which the stomach empties its contents into the small intestine,' explains Dr. Ashwin Sharma from online pharmacy MedExpress. 'This action can affect the absorption rate of administered oral medications, including hormonal contraceptives, making them potentially less effective.'
There are other factors that mean Ozempic could affect the pill too, as Sharma goes onto explain. 'Common side effects such as nausea and vomiting, particularly prevalent during the initial use of drugs like Ozempic, may further compromise the effectiveness of oral contraceptives if vomiting occurs within a few hours after pill consumption,' he says.
As is often the case, it seems that caution is key until there's more certainty in this complex field. 'The MHRA now specifically advises that patients using oral contraceptives should consider using a barrier method of contraception, such as a condom, or switch to a non-oral contraceptive method for four weeks after starting Mounjaro and for four weeks following each dose increase,' says Sharma.
The NHS warns: 'You can only take liraglutide or semaglutide if they're prescribed for you by a specialist weight management service. A doctor might recommend that you take one of these medicines if diet and exercise changes have not worked on their own.'
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