
Semaglutide (Ozempic) may have an effect on certain forms of hormonal birth control, but research is needed to truly understand the potential effects. Here’s what we know so far.
Semaglutide has been making headlines for its ability to help people manage type 2 diabetes, as well as its off-label use for weight loss.
Known more commonly for the brand names it’s sold under — Ozempic, Wegovy, and Rybelsus — semaglutide slows how fast the stomach empties anything that’s ingested, explains Phillip Kadaj, MD, a medical expert with JustAnswer.
“This creates some theoretical concerns in regard to absorption of medication, including birth control pills,” he says.
Does it depend on the type of birth control?
To be clear: There’s currently no published research exploring the relationship between semaglutide (Ozempic) and the effectiveness of birth control.
However, there’s some concern about semaglutide impacting the effectiveness of birth control pills because of the effects semaglutide has on the digestive system, says Kadaj.
“If the hormones in birth control pills aren’t being fully absorbed because of the delayed emptying from semaglutide, there’s a chance that the pill may not be quite as effective [as if the hormones were being absorbed completely],” he explains.
All birth control pills contain progestin, a synthetic version of the hormone progesterone.
Progestin helps prevent pregnancy by halting ovulation, thickening cervical mucus so it’s harder for sperm to reach a potential egg, and thinning the uterine lining so that there’s nothing a fertilized egg can attach to.
“The concern is that if the progestin isn’t absorbed completely into the body, then ovulation won’t stop,” says Kadaj. And if you’re ovulating, it’s possible to become pregnant.
“Again, this concern around birth control pills is currently more of a theoretical concern than a proven one, as research has not yet been done on the subject,” he says.
No other birth control method — nonhormonal or hormonal — is affected by any changes to the digestive system.
The patch and implant, for example, release hormones into the bloodstream, whereas most intrauterine devices (IUDs) release a hormone into the uterus.
Does it depend on what semaglutide (Ozempic) is being used for?
The potential effects on birth control pills is the same, regardless of whether you’re using semaglutide for type 2 diabetes or weight loss.
Semaglutide causes delayed gastric emptying in both scenarios, says Kadaj.
“If a person is using the drug for either diabetes or weight loss, they may want to consider a non-oral version of birth control such as an IUD, implant, or patch,” he says.
Is there a relationship between your weight and hormone levels?
Hormones are stored in fat cells, so when a person loses body fat, it’s common for their hormone levels to dip, says Kadaj. (If, however, you lose weight but not body fat, your hormone levels may not change).
Although your reproductive hormone levels play a role in your ability to become pregnant, losing body fat doesn’t necessarily tell you whether you’re at risk of unintended pregnancy.
If you have questions about how your weight or weight loss is affecting your hormone levels, as well as what that means for your fertility and risk of pregnancy, consult with an endocrinologist or other healthcare professional.
Why does this medication have a “reproductive potential” warning?
All brands of semaglutide currently come with a “reproductive potential” warning on the label.
“This means that there’s a potential risk of fetal harm,” says Kadaj. As such, it may be best to stop taking the medication during pregnancy, he says.
Current recommendations state that Ozempic should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Wegovy should be discontinued.
Other frequently asked questions
Can semaglutide (Ozempic) affect your fertility?
“There’s no evidence that semaglutide (Ozempic) negatively affects fertility,” says Kadaj.
But there is a link betweenTrusted Source obesity and infertility. So, “in certain cases, if a person is on Ozempic and losing weight, this might actually improve fertility,” he says.
What happens if you become pregnant while taking semaglutide (Ozempic)?
According to the medication’s prescribing information, pregnant rats, rabbits, and monkeys that received semaglutide (Ozempic) experienced higher rates of pregnancy loss, birth defects, and low birth weight.
It’s unclear whether these effects are possible in humans. There are limited data on semaglutide (Ozempic) use in pregnant people.
Most healthcare professionals advise against semaglutide (Ozempic) use during pregnancy.
If you’re currently taking semaglutide (Ozempic) and test positive for pregnancy, consult with your prescribing doctor as soon as possible. They can advise you on any next steps, including how to safely discontinue use.
Can Wegovy or tirzepatide (Mounjaro) affect birth control efficacy?
Wegovy has the same active ingredient as Ozempic — semaglutide — so the potential risk of reduced birth control efficacy would be the same, says Kadaj.
“Mounjaro has a similar mechanism of action to Ozempic, so it would also have the same theoretical concerns,” he says.