PCOS—Polycystic Ovary Syndrome—is a hormonal and metabolic condition that can affect everything from your cycle to your skin to how your body handles weight. It shows up differently for everyone, which is why finding the right treatment can feel like a frustrating game of trial and error.
So when women on GLP-1 medications such as Ozempic, Wegovy and Zepbound started sharing that some of their PCOS symptoms felt more manageable, the conversation took off. A few noticed more regular cycles. Others felt fewer cravings or steadier energy. For many, it felt like their bodies were finally easing into a rhythm.
But not everyone sees those changes, and experts say there’s a reason for the mixed results. GLP-1s tend to help women whose PCOS is tied to metabolic issues such as insulin resistance, whereas those with other PCOS drivers may not notice much of a shift. Ahead, experts explain how GLP-1s may support symptom relief.
Featured Experts
- Heather Huddleston, MD is a reproductive endocrinologist in San Francisco, CA
- Ayla Barmmer, MS, RD, LDN is a registered dietitian in Concord, MA
Why PCOS Symptoms Look So Different for Everyone
PCOS looks different for everyone, but many women share one underlying issue: insulin resistance. It simply means the body isn’t using insulin efficiently, and that can impact weight, cravings, skin, hair and even how regularly you ovulate.
“Patients with PCOS who are impacted by insulin resistance and a higher BMI will see the biggest benefit when starting a GLP-1,” says San Francisco, CA reproductive endocrinologist Heather Huddleston, MD, chief medical advisor at Allara Health. “Not all patients with PCOS have detectable insulin resistance, and some are lean—right now we don’t have reason to believe that these patients would see any benefit in taking a GLP-1.”
That’s where nutrition and metabolic health come into the picture. Registered dietitian and FullWell Fertility founder Ayla Barmmer, MS, RD, LDN, adds that insulin resistance is one of the most common metabolic features of PCOS because of how closely insulin interacts with ovarian hormone function. “Many women with PCOS have cells that are less responsive to insulin. To compensate, the body produces more insulin and those higher levels can increase androgen production”—the hormones responsible for symptoms such as acne, hair changes and cycle disruption—”which can worsen issues like irregular periods and unwanted hair growth.”
Nutrition is part of that cycle. Diets high in refined carbs, low in fiber or low in protein can keep insulin elevated throughout the day, while stabilizing blood sugar with protein, slow-digesting carbs and essential nutrients can help improve metabolic symptoms over time.
How GLP-1 Medications Work in the Body
GLP-1 medications get a lot of attention for weight loss, but for women with insulin-resistant PCOS, their biggest impact comes from how they help steady blood sugar throughout the day. Barmmer explains it this way: “GLP-1 receptor agonists mimic a hormone we naturally release after meals. They slow gastric emptying, help stabilize post-meal glucose and increase satiety signals to the brain.” In turn, this can ease the metabolic strain that drives symptoms for many with PCOS.
The PCOS Symptoms That May Improve on GLP-1s
For women whose PCOS is tied to insulin resistance, the first changes tend to be subtle but noticeable. Many describe feeling more in control of their appetite and less pulled into the intense hunger swings that often come with blood-sugar highs and lows. “Most patients notice early changes like reduced appetite and initial weight loss in 4–8 weeks,” says Dr. Huddleston.
As blood sugar becomes more stable, other shifts often follow. Improvements in glucose and insulin levels typically show up within a couple of months, and for some women, that’s when their cycles start to fall into a more predictable rhythm. “Improvements in glucose, insulin and menstrual regularity are often seen within 8–12 weeks,” she explains. “Ovulatory improvements occur over several months.”
Symptoms driven directly by elevated androgens—such as acne, hair thinning or unwanted hair growth—aren’t the main targets of GLP-1 medications. But as metabolic health steadies, Dr. Huddleston notes that some women may still see mild improvements, especially with acne.
Why GLP-1s Don’t Help Everyone With PCOS—and How to Use Them Wisely
Because not all PCOS is driven by insulin resistance, GLP-1s naturally won’t work for everyone. If your symptoms are tied to adrenal function, inflammation or other hormonal pathways, an insulin-targeting medication just doesn’t hit the underlying cause.
For those who do respond, GLP-1s work best alongside other support—not as a standalone fix. “GLP-1s work best as part of a comprehensive treatment plan,” Dr. Huddleston says. That usually means pairing them with nutrition guidance, movement and the right supplement support—and using additional treatments for cycle irregularity or androgen-driven symptoms when needed.
In short, GLP-1s can be hugely helpful for the women they’re actually meant to help, but they aren’t a blanket solution for everyone. When they’re used intentionally and folded into a plan that reflects your version of PCOS, that’s when they really make sense.
