Obesity Drugs and Birth Control Pills: What to Know About Them

Medications used to treat type 2 diabetes, especially those known as GLP-1 drugs, like Mounjaro, are grabbing attention lately. They’re not just for diabetes anymore; people are also using it to lose weight. But there’s a catch for people who use birth control pills. If you’re on both oral contraceptives and a GLP-1 drug, like Mounjaro, you might need to rethink your birth control strategy. These weight loss drugs might make your birth control pills less effective. 

This issue has been a hot discussion on social media groups in recent weeks, where some users have shared their experiences of unexpected pregnancies while using these weight loss drugs alongside hormonal birth control. So, Let’s dig into why GLP-1 drugs, mainly mounjaro Injections, might affect how well oral contraceptives work, how these drugs interact with other forms of birth control, and what you should keep in mind when using both contraceptives and GLP-1 drugs.

Weight Loss Drugs & the Effectiveness of Oral Contraceptives

GLP-1 medications, like Ozempic, Wegovy, and Mounjaro, work by slowing down how quickly your stomach empties food. This means that when you eat, the food stays in your stomach for a longer time. Because the food and anything else you consume, including medications, stay in your stomach for a longer period of time, it can change how your body absorbs these pills. This means that if you’re using birth control pills, these GLP-1 medications could potentially reduce their effectiveness in preventing pregnancy. It’s crucial to keep this in mind when taking any of these medicines.

Among these medications, Mounjaro is the only one that specifically advises using an additional method of contraception. This caution is suggested both when you start taking Mounjaro or if your dose is increased. The reason behind this advice is to ensure that the effectiveness of oral birth control pills isn’t reduced because of the slower stomach emptying effect of the drug. 

What Studies Say About This?

Specifically, a study mentioned in the Mounjaro package insert discovered something interesting. When people took a one-time dose of 5 mg of Mounjaro, the effectiveness of a common type of birth control pill (one that has ethinyl estradiol and norgestimate) was reduced by 20%. It’s a crucial point to consider, especially if you’re relying on this kind of contraception.

[Ethinyl Estradiol & Norgestimate- These are two common active ingredients in many combined oral contraceptive pills (Seasonique, Sronyx, Lessina, Altavera, and others.)]

This study focused on how a medication affects the body’s process of digesting food, particularly after a 5 mg dose. This is important because tirzepatide acts differently than similar drugs, like Victoza, Ozempic, and Trulicity. These drugs, unlike tirzepatide, don’t significantly change how birth control pills are absorbed in the body. Tirzepatide is unique because it targets two areas in the body that control blood sugar: GLP-1 and GIP. This might be why it also affects how the body absorbs other medications. Additionally, common side effects of these drugs, such as nausea and vomiting, could also interfere with the effectiveness of birth control pills. If someone throws up soon after taking a birth control pill, it might not work as intended.

GLP-1 drug Mounjaro could reduce the effectiveness of birth control pills

Did you know that around 42% of women in the U.S. are dealing with obesity? Surprisingly, 40% of them are in the age group of 20 to 39. These new medications can enhance fertility, especially for women with conditions like polycystic ovary syndrome (PCOS). But only one drug, Mounjaro injections, currently mentions a warning about its impact on birth control pills. Unfortunately, it seems that some doctors might not be aware of or counseling patients about this risk. Additionally, we’re not certain if other drugs in the same category, such as Ozempic and Wegovy, pose similar risks, as the available data is unclear.

How Do I Know If My Hormones Are Affecting My Weight?

Hormones are often found in our body’s fat cells. So, when someone loses body fat, their hormone levels might also go down. However, it’s important to know that if you’re losing weight but not specifically losing fat, your hormone levels might stay the same. Your reproductive hormones have an impact on your chances of getting pregnant. But, just losing body fat doesn’t directly tell us if there’s a higher or lower chance of unintended pregnancy. It’s quite complex how our weight or losing weight affects our hormones, and in turn, our fertility and pregnancy risks. To really understand what’s going on, it’s good to consult with an endocrinologist or another healthcare expert. They can give you the right advice and information based on your specific situation.

People With PCOS Who Are Taking GLP-1 Drugs

GLP-1 medications are being used more often to help manage polycystic ovarian syndrome (PCOS). This is a condition where women experience hormonal imbalances and metabolism issues, which can affect their ovaries. The ovaries may not develop eggs properly or release them during ovulation, which can make it difficult for a woman to get pregnant. 

Recent studies show that GLP-1 medications are really good at reducing body weight, waist size, and improving insulin resistance in women with PCOS, even more effective than a common medication called metformin. However, these medications can sometimes cause side effects like headaches and nausea.

It’s especially important for women with PCOS who are on GLP-1 treatments to think about birth control. This is because when GLP-1s improve metabolic health and insulin resistance, women who previously had trouble ovulating may start to have more regular menstrual cycles and become more fertile. This is great for their health, but it also increases the chance of an unexpected pregnancy.

Is It Safe to Take GLP-1 Drugs During Pregnancy?

If you’re pregnant or planning to get pregnant, it’s important to be careful about the medications you take, especially those for weight loss. Right now, doctors don’t have enough information on the effects of GLP-1 medications, like Mounjaro, during pregnancy or breastfeeding. So, they usually suggest stopping these drugs if you’re pregnant or nursing. The reason is that animal studies, like those on rats and rabbits, have shown some risks to babies when exposed to a drug called tirzepatide, which is in Mounjaro.

However, it’s also crucial to remember that not managing diabetes well during pregnancy can definitely harm both the mother and baby. In some cases, if the benefits of taking tirzepatide outweigh the risks, a doctor might still recommend it. But, if you’re using any GLP-1 medication and you’re pregnant or trying to conceive, talk to your healthcare provider as soon as possible.

Interaction of Other Forms of Contraception With GLP-1 Drugs

When taking Mounjaro, it’s important to think about how it interacts with birth control pills. The instructions that come with Mounjaro suggest that if you’re using the pill for contraception, you might want to switch to another form of birth control or use something extra, like condoms, for the first four weeks after you start taking Mounjaro and for four weeks after each time your dose goes up. This is because there’s some uncertainty about how effective the pill will be during these times.

Practically speaking, this means you should have a backup plan for birth control for at least eight weeks, or possibly longer if you’re gradually increasing your Mounjaro dose. The dose can go up to 15 mg weekly, with increases of 2.5 mg every four weeks. It’s always a good idea to have a backup birth control method that doesn’t depend on being taken by mouth. There are plenty of options like condoms, IUDs (intrauterine devices), the NuvaRing, arm implants, or injections. According to the Mounjaro packaging, birth control methods that don’t involve hormones shouldn’t be affected by the drug, so if you’re using one of these, you don’t need to worry about Mounjaro making them less effective.

Does Birth Control Make You Gain Weight?

Hormonal birth control, like the daily pill, is a reliable method for women to avoid pregnancy. However, every medication can have side effects, and for the pill, one of these might be weight gain. Here’s how it works: the pill stops ovulation – that’s when an egg is released from the ovaries – by releasing female hormones into the body.

Now, you might be wondering about weight gain. Some people do notice a bit of weight gain when they start taking the pill, but this is usually not a big deal and can be handled well. Research has shown a possible link between the pill and weight gain. For instance, a study in 2020 observed that people on the combined pill, which has two types of hormones, saw a slight increase in body fat and a decrease in muscle mass, especially in those who were trying to lose weight.

But remember, everyone’s body reacts differently to medications, so it’s not a one-size-fits-all situation. If you’re concerned about weight changes or any other side effects, it’s always a good idea to chat with your doctor. They can help you figure out the best option for your health and lifestyle.

Types of Birth Control Associated With Weight Gain

Despite the fact that these pills haven’t been associated with significant, long-term weight gain, other types of birth control may have a greater impact.

Birth Control Shot

The birth control shot is a simple method to prevent pregnancy. It’s made with a hormone called medroxyprogesterone acetate, which is a type of progestin. You’ll need to visit a healthcare professional to get this shot, which can be given in your arm or buttocks. It’s done every three months. One thing to keep in mind is that some people experience weight gain with this shot. Studies show that with Depo-Provera, a well-known brand of this shot, you might gain around 3 pounds in a year, and possibly up to 14 pounds over 10 years. It’s also been linked to an increase in body fat.

Intrauterine Devices (IUDs) and Birth Control Implants

Let’s talk about two popular types of long-term birth control: birth control implants and intrauterine devices (IUDs). These are often called ‘LARCs’, which stands for long-acting reversible contraceptives. Why? Because they’re effective at preventing pregnancy for many years, and once you remove them, their effect stops. Now, there are different kinds of IUDs and implants, and they’re pretty interesting. IUDs are tiny devices that a healthcare provider places inside the uterus. On the other hand, the implant is a small device that’s inserted under the skin of your arm.

What’s fascinating is that some people notice a bit of weight gain when they use these methods over a long time. Let’s break it down:

1. Hormonal IUDs: These release a hormone called progestin. On average, users might gain around 1.5 pounds in a year, and this could add up to about 9 pounds over 10 years.
2. Non-hormonal IUDs: These are also known as copper IUDs because, well, they contain copper! This type is linked to an average weight gain of about 0.5 pounds in a year, and around 11 pounds over 10 years.
3. Birth control implants: Like hormonal IUDs, these also release progestin. Studies suggest that implants might lead to a bit more weight gain compared to methods that don’t use hormones.

Can Ozempic Interfere With Birth Control?

In simple terms, there’s a theoretical concern that taking Ozempic might impact how well certain medications work in preventing pregnancy by affecting their levels in the bloodstream. However, real-world trials didn’t find any specific problems with medications taken by mouth in people using Ozempic. While the drug’s label mentioned a slight influence on the levels of ethinyl estradiol/levonorgestrel (components of some contraceptives), it wasn’t significant enough to suggest changing the recommended dosage. Doctors should still be aware of the potential for delayed absorption, but overall, it seems like there’s no major issue in practice.

Can I take Ozempic while on birth control?

Sure thing! If you’re using Ozempic or a similar GLP-1 agonist and you’re also on birth control, it’s generally okay to stick with oral contraceptives if they’re suiting you well. This is especially true if you’re not dealing with issues like vomiting or diarrhea, which most GLP-1 users don’t experience. So, no worries there! Keep doing what works best for you. 

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Concluding Altogether

Mixing medications like GLP-1 drugs, such as Mounjaro with birth control can be the wrong choice one could make, especially with the emerging evidence of their interactions. These weight-loss drugs are beneficial for conditions like PCOS and obesity but they might reduce the effectiveness of oral contraceptives. It’s crucial for those on GLP-1 medications to consider additional or alternative birth control methods. Understanding how these drugs interact with hormonal levels and body weight is essential for making informed healthcare decisions. Always consult with healthcare professionals to tailor your treatment and contraception plan to your specific needs, ensuring both efficacy and safety in managing your health.