Women who struggle with PCOS find help using Ozempic, Mounjaro

(NEW YORK) — Branneisha Cooper of Texas said she was diagnosed during her senior year of high school with polycystic ovary syndrome, or PCOS, a reproductive hormone imbalance that can cause problems with the menstrual cycle and lead to the formation of multiple ovarian cysts and infertility, according to the U.S. Office on Women’s Health.

The exact cause of PCOS is unknown, but people with this condition have higher levels of androgens, such as testosterone, and insulin that can lead to insulin resistance which is a risk factor for Type 2 diabetes.

Cooper, now 26, said she suffered for over a decade with irregular menstrual cycles, hormonal imbalances and weight gain.

That changed late last year, she said, when her doctor prescribed her Mounjaro, an injectable medication approved by the Food and Drug Administration in May 2022 to treat Type 2 diabetes.

“[My doctor] said, ‘There’s this great medication and I have a couple of women on it already who also have PCOS,'” Cooper told Good Morning America, adding, “Since starting on Mounjaro, it has honestly just been like a stress relief. I feel like a weight has been lifted off my shoulders.”

Since starting on the medication in November, Cooper said she has had a menstrual cycle regularly each month, has experienced reduced inflammation and has lost over 40 pounds.

She said she is also thinking, for the first time since her diagnosis, about becoming pregnant in the future, something she said she was previously told was unlikely to happen.

“For me especially, since I’m taking this for PCOS, this is so much more than weight loss for me, Cooper said. “Now that my cycles are regular again and I’m ovulating, it’s like I can think again about that thought I’d pushed back in my mind, of being a mom.”

Cooper is among a growing number of women with PCOS who are turning to medications like Mounjaro and Ozempic to treat their condition. The medications have been in the headlines recently for their growing popularity as drugs used for weight loss.

Like Mounjaro, Ozempic is approved by the FDA to treat Type 2 diabetes, but some doctors prescribe the medication “off-label” for weight loss, as is permissible by the FDA.

Many women, including Cooper, are talking about the medications on social media, where they say they’re finding a community of women who have long struggled with PCOS and struggled to find any medications to ease their symptoms.

Symptoms of PCOS can include everything from irregular or absent periods to excessive facial hair, acne and obesity. The exact cause of PCOS is not known.

The condition affects 1 in 10 women of childbearing age, according to the Office on Women’s Health.

“Prior to being on this medication, I thought it was just a me problem, that there was just something that I wasn’t getting right that other people were,” Cooper said. “It wasn’t until I [went] on Mounjaro and realized it’s a chronic disease … and you weren’t the problem.”

Tiffany Groves, who also lives in Texas, said she too struggled with PCOS for nearly a decade before going on Mounjaro last October, after learning about the medication on TikTok.

She was prescribed the medication off-label to help treat PCOS, and said she has since experienced regular menstrual cycles for the first time in her life. The 38-year-old said she has also lost around 43 pounds.

“This whole time I’ve been living life and thinking it’s normal to think about food all the time and then all of a sudden, you don’t think about food,” Groves told GMA of her experience on Mounjaro. “I can just eat a little bit and be perfectly fine.”

How drugs like Ozempic, Mounjaro can help PCOS

Typically, treatment options to manage PCOS symptoms include hormonal birth control and anti-androgen medicines as well as weight loss, according to the Office on Women’s Health.

Dr. Rekha Kumar, an endocrinologist at Weill Cornell Medicine and NewYork-Presbyterian and an expert in obesity and PCOS, said that drugs like Ozempic and Mounjaro can be helpful in treating the condition because they help address one of its main underlying problems, insulin resistance.

“It’s not necessarily that we’re using the meds to treat PCOS, but the meds can be helpful for one of the symptoms of PCOS, which is the actual weight gain and hormonal drive to eat carbohydrate because of the insulin resistance,” Kumar said, adding, “What we’ve learned in the past 20 years is that PCOS is actually an insulin-carbohydrate-metabolism problem called insulin resistance, meaning the body makes more insulin in response to carbohydrates.”

She continued, “And what people often forget about insulin is that it’s a fat storage-promoting hormone, so the more insulin your body is making, the better you are at storing fat.”

The active ingredient in Mounjaro, tirzepatide, works by activating two naturally produced hormones in the body: glucagon-like peptide-1, known as GLP-1, and glucose-dependent insulinotropic polypeptide, or GIP.

The combination is said to slow the emptying of the stomach by making people feel full longer, suppress appetite by slowing hunger signals to the brain, and help reduce blood sugar.

Ozempic is made from a compound called semaglutide, which works by helping the pancreas release insulin to move sugar from the blood into body tissues.

It also works by slowing down movement of food through the stomach and curbing appetite, thereby causing weight loss.

Ozempic and Mounjaro cannot be given to patients with certain medical conditions, including medullary thyroid cancer, pancreatitis or gallstones. Side effects of the medications can include severe nausea and constipation.

Kumar said she has been prescribing this class of medications to patients with PCOS for over a decade, saying, “The people that really know the science about how these medicines work as well as the science of PCOS have understood the link for some time.”

Kumar noted that as drugs like Ozempic and Wegovy have risen in popularity in recent months, she has found it harder to get her prescriptions for patients approved by insurance.

Both Ozempic and Wegovy are considered off-label for PCOS. Without insurance coverage, the cost of the medications can run over $1,000 per month.

“We used to be able to prescribe these a little easier, before the Ozempic craze,” Kumar said. “Because now there’s so much inappropriate prescribing that even the one-off cases that might do really well on these medicines are getting denied because there’s so much scrutiny on each prescription.”

Kumar and other doctors say that patients having a hard time accessing Ozempic or Mounjaro due to shortages or insurance problems should speak to their doctor about alternative options within the same class of medications.

Because PCOS is many times diagnosed in women as they are experiencing fertility struggles, Kumar said it’s also important for women to know that medications like Ozempic and Mounjaro should not be taken during pregnancy or while trying to become pregnant.

“We just have to really make sure that patients understand the risks and the unknowns of getting pregnant on these medicines, because when we do treat people’s insulin resistance, they become more fertile,” Kumar said. “Women who thought that they could never get pregnant, if you’re treating them with these medicines, they might, so we just have to be very careful with educating on the risks.”

The FDA also says in its safety profiles of these drugs that they should not be taken during pregnancy, noting there is “insufficient data” available.

The FDA also explains that the drugs could cause weight loss, and that “weight loss offers no benefit to a pregnant patient and may cause fetal harm.”

The FDA recommends that people discontinue treatment at least two months before they plan to become pregnant.

Both Cooper and Groves said they have plans in place with their doctors to go off Mounjaro if they ever try to become pregnant in the future. Cooper said she anticipates being on Mounjaro “long-term” for PCOS, except for when she tries to have a child.

“It’s treating my PCOS — it’s not curing it, it’s treating it,” Cooper said. “And this is the best I’ve felt my entire adult life.”

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