GLP-1 Receptor Agonists for Weight Loss in Women With PCOS: A Scoping Review of Clinical Effects | Research

The takeaway

GLP-1 receptor agonists consistently reduced weight and BMI in women with PCOS, while also improving metabolic parameters, menstrual regularity, and natural pregnancy rates across eight studies.

All 8 studies showed weight/BMI reduction
Every included study reported consistent weight loss and BMI improvement in women with PCOS using GLP-1 receptor agonists (liraglutide or exenatide)

What the researchers found

All eight included studies uniformly reported reductions in weight and BMI among PCOS patients prescribed GLP-1 RAs (liraglutide or exenatide). Additional benefits included improvements in anthropometric parameters (waist circumference, total fat percentage), glucose homeostasis, cardiovascular inflammatory markers (MR-proANP and MR-proADM), rates of natural pregnancy, and menstrual regulation.

However, findings regarding lipid profile effects were inconsistent across studies. Short-term adverse effects were noted but long-term effects remain undetermined. The studies showed wide geographic diversity, suggesting benefits across racial and ethnic backgrounds.

Why it matters

PCOS affects 6-12% of reproductive-age women and is the leading cause of infertility related to anovulation. Weight management is central to PCOS treatment, but effective pharmacological options have been limited. GLP-1 receptor agonists address multiple PCOS features simultaneously — weight, insulin resistance, metabolic dysfunction, and potentially fertility — making them a particularly attractive therapeutic option for this population.

How the study worked

Scoping review following Joanna Briggs Institute methodology and PRISMA guidelines. Searched Ovid Medline, Web of Science, CINAHL, Cochrane CENTRAL, SCOPUS, and ClinicalTrials.gov from 2012 to 2023. From 811 identified articles (after duplicate removal), eight met eligibility criteria. All were peer-reviewed, published in English, and examined GLP-1 RAs in women with PCOS.

What this study cannot tell us

Only eight studies met inclusion criteria, limiting the evidence base. Most studies used liraglutide or exenatide rather than newer agents (semaglutide, tirzepatide). Long-term effects remain undetermined. The review is a scoping review, not a systematic review with meta-analysis, so effect sizes cannot be pooled. Lipid profile effects were inconsistent. Study designs and outcome measures varied across included studies.

How to read the evidence

This is a scoping review following established JBI methodology and PRISMA guidelines, published in Cureus. The systematic search strategy is strong, but only eight studies qualified, and the scoping review design provides a broad overview rather than quantitative effect estimates.

When this study was published

Published in 2024 with literature through 2023. This review predates the widespread off-label use of semaglutide for PCOS, so the evidence primarily reflects earlier GLP-1 agonists (liraglutide, exenatide).

The bigger picture

GLP-1 receptor agonists are being explored for an expanding list of conditions beyond diabetes. PCOS represents a particularly compelling use case because these drugs address the core metabolic dysfunction driving the syndrome. As more women with PCOS use GLP-1 agonists — including newer agents like semaglutide — understanding their effects on reproductive outcomes and hormonal balance becomes increasingly important.

Questions still open

Would newer GLP-1 agonists like semaglutide and tirzepatide show even greater benefits for PCOS than liraglutide and exenatide?
What are the effects of GLP-1 RAs on androgen levels and hormonal balance in PCOS, beyond weight and metabolic outcomes?
Should GLP-1 RAs be considered first-line therapy for overweight women with PCOS seeking fertility?

Common questions

How do GLP-1 agonists help with PCOS beyond weight loss?

PCOS is driven by insulin resistance, which worsens hormonal imbalances. GLP-1 agonists improve insulin sensitivity, which can help normalize hormone levels. This cascade of improvements explains why these drugs not only reduce weight but also improve menstrual regularity and fertility — addressing the root metabolic dysfunction rather than just symptoms.

Are GLP-1 agonists approved for treating PCOS?

No — GLP-1 agonists are currently approved for type 2 diabetes and obesity, not specifically for PCOS. Their use for PCOS is off-label, meaning doctors can prescribe them based on clinical judgment. This scoping review supports their potential benefits, but more research is needed before they could receive specific PCOS approval.

Read the original research

Clinical Effects of Glucagon-Like Peptide-1 Agonist Use for Weight Loss in Women With Polycystic Ovary Syndrome: A Scoping Review.

Cureus, 16(8), e66691

View on PubMed ↗Publisher’s paper ↗

Citation

Frangie Machado, Melissa; Shunk, Taylor; Hansen, Grace; Harvey, Charles; Fulford, Baylee; Hauf, Shane; Schuh, Olivia; Kaldas, Matthew; Arcaroli, Elena; Ortiz, Justin; De Gaetano, Joseph. (2024). Clinical Effects of Glucagon-Like Peptide-1 Agonist Use for Weight Loss in Women With Polycystic Ovary Syndrome: A Scoping Review.. Cureus, 16(8), e66691. https://doi.org/10.7759/cureus.66691