Can Ozempic or Wegovy be used for menopausal weight gain?

What are Ozempic and Wegovy (semaglutide)? 

Ozempic and Wegovy are brand names for semaglutide, a medication originally designed to manage type 2 diabetes and now also used for weight loss. 

Semaglutide mimics GLP-1 (glucagon-like peptide-1), a hormone that lowers blood sugar levels by increasing insulin production and reducing sugar release from the liver¹. It also slows down how quickly food leaves your stomach, keeping you fuller for longer.

These actions reduce appetite and overall calorie intake, supporting weight loss.

Semaglutide is an injectable medication that is given once-weekly. 

Why Does Weight Gain Happen Around Menopause?

As oestrogen and progesterone levels decline during perimenopause and menopause, metabolism slows down and fat storage patterns shift. This often leads to increased fat around the abdomen and lower back³. It’s estimated that up to 50% of women notice weight gain during this stage of life, with an average gain of around 1.5kg per year².

With semaglutide becoming more common, many women are now asking: could it help manage menopausal weight gain?

Is Semaglutide Approved for Menopause-Related Weight Gain?

Semaglutide isn’t officially licensed specifically for treating menopausal weight gain. However, Wegovy may be prescribed for weight loss if you meet certain clinical criteria⁴:

• BMI of 30 or above, or
• BMI of 27 to 30 plus weight-related health concerns like high blood pressure, type 2 diabetes, or cardiovascular disease.
  

In the UK, Wegovy is available via the NHS only through a specialist weight management service, and generally only after standard approaches (diet and exercise) have been unsuccessful.

Can I take Ozempic for menopause weight gain?

Ozempic and menopause aren’t technically licensed like Wegovy and menopause are. The license (in the UK) for Ozempic is only for patients who are diabetic. Therefore, if you don’t suffer from diabetes but want to use semaglutide in menopause, Wegovy is the “gold standard” option, however, many providers will prescribe Ozempic off license for weight loss too. Afterall, it is the same drug, just a brand name change!

If you are started on either Wegovy or ozempic for menopause weight gain, guidelines currently state that they shouldn’t be used for longer than 2 years⁵.

Does semaglutide help any other menopausal symptoms? 

As you’ve seen, semaglutide would be given to help you lose weight rather than to specifically treat a symptom of the menopause. However, menopause is a challenging time for some women both physically and emotionally, so using medication to achieve a healthy weight may have some other benefits.  

More stable blood sugar levels may help with symptoms like fatigue, hot flashes and mood swings.

Keeping a healthy weight as you go through menopause is important to reduce the risk of heart disease, strokes and high blood pressure as you get older. Therefore, if you use medication to reach a healthy weight, you can reduce these risks. 

Are there any potential side effects of these medications? 

As with all medications, Ozempic and Wegovy have side effects. Some of these are more common than others⁶. 

Common side effects (that may affect up to 1 in 10 people taking the drug), include^1,6: 

• Diarrhoea
• Nausea (feeling sick) 
• Vomiting 
• Tummy pain 
• Constipation

Rarer, but more serious, problems include gallbladder disease, inflammation of the pancreas and kidney issues.

The manufacturers of semaglutide also state that in theory, there is a risk of the drug causing a type of thyroid cancer. Therefore, you can not take this medication if you have a personal or a family history of thyroid cancer. 

Can you use Ozempic or Wegovy if you take hormone replacement therapy (HRT)? 

The short answer is yes you can, but with caution. 

Because semaglutide is relatively new, there’s still uncertainty about how it might affect the absorption of hormones in HRT, particularly oral progesterone. Progesterone is vital to take if you have a womb to prevent the overgrowth of womb lining which can increase the risk of cancer. The British Menopause Society advises women using oral forms of progesterone (such as Utrogestan, Gepretix, micronised progesterone) to consider switching to a hormone-releasing coil or transdermal patches for better reliability⁷.

If you don’t want to switch, you are advised to increase your progesterone dose for the 4 weeks after starting Ozempic or Wegovy and for 4 weeks after every dose increase.

Additionally, if you’re overweight and using oral oestrogen, switching to transdermal forms (gels, sprays, or patches) can reduce your risk of developing blood clots⁷.

What else can help with menopausal weight gain?

While semaglutide may be effective, it isn’t suitable, or necessary, for everyone. Long-term weight management is most successful when combined with these key strategies:

• Cardio exercise: Aim for 150 minutes per week of moderate-intensity activity (or 30 minutes, five days per week). This helps burn calories, improve insulin sensitivity, and support mental health^8,9.
  
• High-protein meals: Protein helps control hunger and supports muscle building, which boosts metabolism¹.
  
• Stress reduction: Chronic stress raises cortisol, a hormone that increases fat storage, especially around the midsection.
  
• Better sleep: Quality sleep supports metabolism and recovery from exercise. For tips on improving your sleep during perimenopause, check out The Lowdown’s guide.

Managing weight during menopause can feel frustrating, but you’re not alone and help is available. If you’re considering medications like Wegovy or Ozempic, speak to a healthcare professional to assess whether it’s a safe and appropriate option for you. And if you’re on HRT, don’t forget to discuss how these treatments may affect your overall plan.