The use of GLP-1: receptor agonist medications for benign gynecology

Curr Opin Obstet Gynecol. 2025 Aug 1;37(4):279-284. doi: 10.1097/GCO.0000000000001028. Epub 2025 Apr 4.

Abstract

Purpose of review: This review summarizes research on glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications and their relevance in the treatment of benign gynecologic conditions.

Recent findings: GLP-1 RA use is increasing in popularity in the USA, with expanding applications for gynecology. GLP-1 RA may improve weight loss, metabolic dysfunction, and menstrual regularity in patients with polycystic ovarian syndrome (PCOS). Side effects of these medications, including delayed gastric emptying, impact perioperative management, and the efficacy of oral contraception for patients on tirzepatide. Research is ongoing for their use in infertility and endometrial hyperplasia treatment. Recent studies showed a higher spontaneous conception rate and pregnancy rate with combined GLP-1 RA and metformin therapy when taken before IVF. Further studies are needed to establish recommendations for GLP-1 RA medication use in treating gynecologic conditions.

Summary: With obesity, diabetes, and cardiovascular disease on the rise in the USA, the use of GLP-1 RA medication is also increasing. GLP-1 RAs are currently indicated for the treatment of diabetes with cardiovascular disease to improve glycemic control, in addition to weight loss management. Gynecologists must consider the implications of GLP-1 RA medication in treating metabolic disorders, such as PCOS, contraceptive management, perioperative care, and potential impacts on infertility and endometrial hyperplasia.

Keywords: GLP-1 receptor agonist medications; contraceptive management; perioperative care; polycystic ovarian syndrome.

Publication types

  • Review

MeSH terms

  • Endometrial Hyperplasia / drug therapy
  • Female
  • Genital Diseases, Female* / drug therapy
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Metformin / therapeutic use
  • Obesity / drug therapy
  • Polycystic Ovary Syndrome / drug therapy
  • Pregnancy
  • Weight Loss / drug effects

Substances

  • Glucagon-Like Peptide-1 Receptor Agonists
  • Hypoglycemic Agents
  • Metformin