GLP-1 prescribing for reproductive-age women surged in Australia with most lacking contraception and some becoming pregnant | Research

The takeaway

Australian GLP-1 prescribing for reproductive-age women increased from 0 to 14.9/1,000 for non-diabetic women by 2022, with only 21.2% using contraception at initiation and 232 pregnancies within 6 months of prescribing—highlighting reproductive safety gaps.

Only 21% using contraception
As GLP-1 prescribing for reproductive-age women surges (90% non-diabetic), less than 1 in 4 have documented contraception—with 232 pregnancies within 6 months of prescribing

What the researchers found

1.6M women aged 18-49. GLP-1 prescribing: 0 → 14.9/1,000 (non-T2DM) by 2022. 90.5% of 2022 prescriptions: non-diabetic. Contraception documented: only 21.2%. Pregnancies within 6 months: 232/10,781. T2DM prescribing: 13.0 → 88.5/1,000.

Why it matters

GLP-1 drugs are contraindicated in pregnancy due to insufficient safety data. The finding that <25% of reproductive-age women have contraception at treatment initiation, with hundreds of pregnancies occurring, represents a patient safety crisis.

How the study worked

Retrospective open cohort study. MedicineInsight general practice data (1.6M women, 2011-2022). Age-standardized incidence. Contraception overlap analysis.

What this study cannot tell us

General practice data may miss specialist prescribing. Contraception may be underrecorded. Pregnancy outcomes not detailed. Australian population.

How to read the evidence

Large population-based cohort study with 1.6 million women. Strong for describing prescribing patterns and safety gaps.

When this study was published

Published in 2025; data 2011-2022.

The bigger picture

The weight loss drug boom has created a reproductive safety gap. As GLP-1 drugs are increasingly prescribed to young women for cosmetic weight loss, the teratogenic risk becomes a major public health concern without systematic contraception counseling.

Questions still open

Should pregnancy testing be mandatory before GLP-1 prescribing?
Should GLP-1 drug labels require contraception counseling?
What are the actual fetal outcomes when pregnancies occur on GLP-1 drugs?

Common questions

Can I get pregnant while taking a GLP-1 drug?

GLP-1 drugs are NOT safe during pregnancy and should be stopped at least 2 months before conception. However, this study found 232 Australian women became pregnant within 6 months of starting a GLP-1 drug, and only 21% were using contraception. If you are of childbearing age, reliable contraception is essential while taking these drugs.

Why are so many young women taking GLP-1 drugs without contraception?

The explosive growth of GLP-1 drug prescribing for weight loss—90% of prescriptions for young women were NOT for diabetes—has outpaced safety counseling. Many prescribers and patients may not realize these drugs require pregnancy prevention. This study highlights an urgent need for systematic contraception counseling.

Read the original research

Incidence of GLP-1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011-2022: a retrospective open cohort study.

The Medical journal of Australia, 223(7), 365-371

View on PubMed ↗Publisher’s paper ↗

Citation

Thapaliya, Kailash; Sweeting, Arianne; Black, Kirsten I; Poprzeczny, Amanda; Mazza, Danielle; Grzeskowiak, Luke E. (2025). Incidence of GLP-1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011-2022: a retrospective open cohort study.. The Medical journal of Australia, 223(7), 365-371. https://doi.org/10.5694/mja2.70026