Weight Management And Polycystic Ovary Syndrome (PCOS): How Mounjaro Can Help

Are you struggling with weight management? This can be especially challenging for people with Polycystic Ovary Syndrome (PCOS). Here, our Levity experts unpack the potential that Mounjaro has to support weight loss and improve metabolic health in those with PCOS.

Overview of Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a common condition that affects 8-13% of women of reproductive age. [1] It’s linked to hormonal imbalances, ovulation difficulties, and small cysts on the ovaries. PCOS is a leading cause of infertility and is also associated with certain metabolic and cardiovascular health risks. 

Most individuals with PCOS have insulin resistance or high insulin levels, [2] which is when the body doesn’t respond properly to insulin and results in high blood sugar levels. Elevated insulin levels stimulate the ovaries to produce more androgens, which are male hormones such as testosterone. This can lead to symptoms of PCOS.

Definition of PCOS

PCOS is diagnosed when at least two of the following three criteria are present:

• Irregular ovulation (either infrequent or absent)
• Elevated levels of androgens, which can cause symptoms like excess hair growth
• Polycystic ovaries, identified on an ultrasound as multiple small follicles on the ovaries. [3]

Common Symptoms

You might start noticing symptoms of PCOS in your late teens or early 20s. But don't worry, PCOS looks different for everyone. 

Remember, not everyone with PCOS will have every symptom, and they can range from mild to more severe. Common symptoms include:

• Irregular periods
• No periods at all
• Difficulty getting pregnant
• Excessive hair growth on the face, chest, back or buttocks (this is termed hirsutism)
• Weight gain
• Thinning hair or hair loss
• Oily skin or acne

Causes and Risk Factors

The exact cause of PCOS is not fully understood. It’s believed to result from a combination of lifestyle, genetic and environmental factors.

• Genetics: Family history plays a significant role in PCOS. In fact, research suggests that genetics can influence the likelihood of developing PCOS by up to 79%. [4]
• Hormonal imbalances: High levels of androgens and insulin resistance are key contributors to PCOS. Insulin resistance leads to increased androgen production, disrupting ovulation. [5]
• Diet and lifestyle: Diets high in refined carbohydrates and sugar can worsen insulin resistance and contribute to the progression of PCOS. [6, 7]
• Obesity: In particular, abdominal obesity (which is excess fat around the abdomen region) increases insulin resistance in women with PCOS. This, in turn, contributes to higher androgen levels. The resulting hormonal imbalance can make it harder to manage weight, which may further contribute to obesity, creating a harmful cycle that can be difficult to break. [8, 9]
• Unhealthy gut bacteria: Alterations in the gut microbiome are increasingly recognised as contributing to PCOS, through links with insulin resistance, increased androgen production and inflammation. [10]

Mounjaro: An Overview

Mounjaro contains the active ingredient tirzepatide, which works by inhibiting both gastric inhibitory polypeptide (GIP) and glucagon-like peptide 1 (GLP-1). It mimics the effects of two naturally occurring hormones in your gut, helping to balance blood sugar levels and control appetite, supporting weight loss. Like all medications, Mounjaro can cause side effects, although they are usually mild and tend to improve as your body gets used to the medication.

Benefits of Mounjaro for PCOS

Weight Loss and Management

Mounjaro has been shown to result in an average of 20.9% body weight loss in 72 weeks. [11] There are currently no published studies looking at the use of Mounjaro in women with PCOS. However, due to the medications' beneficial effects on weight loss and insulin resistance, it is hypothesised to be beneficial for PCOS. [12] Weight loss can support more frequent periods and regular ovulation. 

Addressing Insulin Resistance

Mounjaro has the potential to improve insulin resistance in women with PCOS due to several mechanisms, including by: 

1. Enhancing insulin secretion after eating: Mounjaro helps to control blood sugar levels and improve the body’s sensitivity to insulin.
2. Reducing the production of a hormone in the body called glucagon, which is normally responsible for increasing blood sugar levels during periods of fasting.
3. Suppressing appetite and slowing the rate of digestion: Mounjaro leads to decreased food intake and contributes to weight loss, improving insulin sensitivity levels.

Potential Impact on Fertility

There is currently no direct evidence on how Mounjaro affects fertility. However, a recently published meta-analysis studying the effects of other GLP-1 medications, such as semaglutide and liraglutide, in women with PCOS found a 72% increase in the likelihood of achieving a natural pregnancy compared to controls. [13] This increase was due to the effects of the GLP-1s on weight loss and menstrual regularity. Given that Mounjaro is also a GLP-1 medication, it could positively impact fertility in women with PCOS, although this remains to be confirmed in clinical trials. 

Frequently Asked Questions about Mounjaro and PCOS

Effectiveness of Mounjaro

Mounjaro is currently approved to treat obesity in people with a BMI of 30 and above, or with a BMI of 27 and above in the presence of at least one weight-related health issue such as prediabetes or high blood pressure. As PCOS is considered to be a weight-related health issue, you may be eligible for Mounjaro if your BMI is at least 27.

The NHS states that losing 5% of your body can significantly improve symptoms of PCOS, and Mounjaro can help you lose up to 20.9% in just over a year. [11]

Alternative Treatment Options for PCOS

While there is no cure for PCOS, symptoms can be managed through lifestyle changes, medications, and surgical interventions for fertility problems.

Lifestyle Changes and Diet

Losing weight has been shown to improve insulin sensitivity, lower androgen levels and result in more regular periods in women with PCOS. [14] Vigorous exercise (such as running, swimming or walking uphill) has been found to result in significant improvements in PCOS symptoms. [15] In addition, foods with a low glycemic index (GI) have been shown to also improve symptoms of PCOS. [16] These foods cause a slow rise in blood sugar, helping you feel full for longer and include whole-grains, non-starchy vegetables and fruits.

Other Medications

Medication recommendations for PCOS depend on the symptom being treated. For example, the contraceptive pill is often prescribed to treat irregular periods. To encourage ovulation, clomifene can be prescribed to women who are trying to get pregnant by stimulating egg release from the ovaries. Metformin can be prescribed to improve insulin sensitivity and blood sugar levels, however this is considered off-label.

Natural Remedies

Herbal supplements for PCOS were reviewed in a 2014 publication that found Vitex Agnus-Castus (chasteberry) and Cimicifuga Racemosa (Black Cohosh) to be effective in managing irregular ovulation. However, the evidence surrounding this is limited by small sample sizes and study design variability. [17] 

Ready to Start Your Weight Loss Journey?

At Levity we we offer a variety of weight loss medications. These need to be prescribed by a healthcare professional, who assesses whether these medications are suitable for you. Find out more here.

References:

1] World Health Organization. Polycystic ovary syndrome. Available at: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome (Accessed: [5/2/25]).

2] Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertil Steril. 2012 Jan;97(1):18-22. doi: 10.1016/j.fertnstert.2011.11.036. PMID: 22192137; PMCID: PMC3277302.

3] Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF; Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006 Nov;91(11):4237-45. doi: 10.1210/jc.2006-0178. Epub 2006 Aug 29. PMID: 16940456.

4] Vink JM, Sadrzadeh S, Lambalk CB, Boomsma DI. Heritability of polycystic ovary syndrome in a Dutch twin-family study. J Clin Endocrinol Metab. 2006 Jun;91(6):2100-4. doi: 10.1210/jc.2005-1494. Epub 2005 Oct 11. PMID: 16219714.

5] Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012 Dec;33(6):981-1030. doi: 10.1210/er.2011-1034. Epub 2012 Oct 12. PMID: 23065822; PMCID: PMC5393155.

6] Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M, Verbanac D, Saso L. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome-Narrative Review. Nutrients. 2021 Jul 18;13(7):2452. doi: 10.3390/nu13072452. PMID: 34371961; PMCID: PMC8308732.

7] Xenou M, Gourounti K. Dietary Patterns and Polycystic Ovary Syndrome: a Systematic Review. Maedica (Bucur). 2021 Sep;16(3):516-521. doi: 10.26574/maedica.2020.16.3.516. PMID: 34925611; PMCID: PMC8643565.

8] Dahan MH, Reaven G. Relationship among obesity, insulin resistance, and hyperinsulinemia in the polycystic ovary syndrome. Endocrine. 2019 Jun;64(3):685-689. doi: 10.1007/s12020-019-01899-9. Epub 2019 Mar 21. PMID: 30900204; PMCID: PMC6557720.

9] Al-Jefout, M., Alnawaiseh, N. & Al-Qtaitat, A. Insulin resistance and obesity among infertile women with different polycystic ovary syndrome phenotypes. Sci Rep 7, 5339 (2017). https://doi.org/10.1038/s41598-017-05717-y

10] Liu R, Zhang C, Shi Y, Zhang F, Li L, Wang X, Ling Y, Fu H, Dong W, Shen J, Reeves A, Greenberg AS, Zhao L, Peng Y, Ding X. Dysbiosis of Gut Microbiota Associated with Clinical Parameters in Polycystic Ovary Syndrome. Front Microbiol. 2017 Feb 28;8:324. doi: 10.3389/fmicb.2017.00324. PMID: 28293234; PMCID: PMC5328957.

11] Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, Kiyosue A, Zhang S, Liu B, Bunck MC, Stefanski A; SURMOUNT-1 Investigators. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med. 2022 Jul 21;387(3):205-216. doi: 10.1056/NEJMoa2206038. Epub 2022 Jun 4. PMID: 35658024.

12] Anala AD, Saifudeen ISH, Ibrahim M, Nanda M, Naaz N, Atkin SL. The Potential Utility of Tirzepatide for the Management of Polycystic Ovary Syndrome. J Clin Med. 2023 Jul 10;12(14):4575. doi: 10.3390/jcm12144575. PMID: 37510690; PMCID: PMC10380206.

13] Zhou L, Qu H, Yang L, Shou L. Effects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review. BMC Endocr Disord. 2023 Nov 8;23(1):245. doi: 10.1186/s12902-023-01500-5. PMID: 37940910; PMCID: PMC10631119.

14] Scragg J, Hobson A, Willis L, Taylor KS, Dixon S, Jebb SA. Effect of Weight Loss Interventions on the Symptomatic Burden and Biomarkers of Polycystic Ovary Syndrome : A Systematic Review of Randomized Controlled Trials. Ann Intern Med. 2024 Dec;177(12):1664-1674. doi: 10.7326/M23-3179. Epub 2024 Nov 5. PMID: 39496172.

15] Patten RK, Boyle RA, Moholdt T, Kiel I, Hopkins WG, Harrison CL, Stepto NK. Exercise Interventions in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Front Physiol. 2020 Jul 7;11:606. doi: 10.3389/fphys.2020.00606. PMID: 32733258; PMCID: PMC7358428.

16] Kazemi M, Hadi A, Pierson RA, Lujan ME, Zello GA, Chilibeck PD. Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Adv Nutr. 2021 Feb 1;12(1):161-178. doi: 10.1093/advances/nmaa092. PMID: 32805007; PMCID: PMC7850057.

17] Arentz, S., Abbott, J.A., Smith, C.A. et al. Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings. BMC Complement Altern Med 14, 511 (2014). https://doi.org/10.1186/1472-6882-14-511