Women taking widely prescribed weight-loss medications may be unaware of potential risks to pregnancy and unborn children, according to researchers at Flinders University.
A new study reveals that most Australian women of reproductive age prescribed GLP-1 receptor agonists—drugs increasingly used for weight loss, including Ozempic—are not using effective contraception despite known pregnancy risks.
Published in the Medical Journal of Australia, the study analyzed records of more than 1.6 million women aged 18 to 49 who visited general practices between 2011 and 2022. Of the 18,010 women who were first prescribed GLP-1 receptor agonists during this period, only 21% reported using contraception.
Originally developed to manage type 2 diabetes, GLP-1 receptor agonists have gained popularity for their appetite-suppressing and weight-loss effects. The study found that most prescriptions are now issued to women without diabetes.
“In 2022 alone, over 6,000 women began treatment with GLP-1s, and more than 90% of them did not have a diabetes diagnosis,” said lead author and pharmacist Associate Professor Luke Grzeskowiak. “We’re seeing widespread use of these medications among women of childbearing age, yet very little evidence that contraception is being considered as part of routine care. These medications can be incredibly helpful, but they’re not risk-free, especially during pregnancy.”
The research found that 2.2% of women became pregnant within six months of starting GLP-1 treatment, with pregnancy rates highest among younger women with diabetes and women in their early thirties without diabetes. Women with polycystic ovary syndrome were twice as likely to conceive, suggesting that weight loss may improve fertility, even when unintended.
Importantly, women who were using contraception at the time of prescription had a significantly lower risk of pregnancy.
Previous animal studies from the University of Amsterdam have linked GLP-1 exposure during pregnancy to reduced fetal growth and skeletal abnormalities. While human data is limited, the potential risks remain concerning.
“While the UK advises that women using GLP-1 receptor agonists should avoid pregnancy and use effective contraception, this guidance is not consistently followed in Australian clinical practice,” Associate Professor Grzeskowiak said. “Reproductive health must be part of every conversation when these drugs are prescribed to women of childbearing age. Clearer guidelines are urgently needed to ensure these medications are used safely and effectively.”
He advises women to discuss the risks and benefits of GLP-1 medications with their GP before use and only take them under medical supervision. The study’s authors call for further research to assess the impact of these drugs on pregnancy and unborn children.
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