Women are advised to combine effective contraception with ‘skinny injections’ | Medical research

Claims that “skinny shots” are fueling an unexpected baby boom have led experts to warn women to pair their use with effective contraception.

Drugs such as Wegovy and Ozempic, both of which contain semaglutide, have become extremely popular, particularly because they can help people lose more than 10% of their body weight.

The medications work by mimicking a hormone in the body called GLP-1 that triggers an increase in insulin production, slows the rate at which food is digested in the stomach, and reduces appetite.

But as their use has exploded, so have reports of women becoming pregnant while taking such drugs — known as GLP-1 receptor agonists.

The Facebook group “I Got Pregnant on Ozempic” has more than 750 members, while threads on social networking site Reddit are full of stories of such experiences.

Although studies confirming a link are lacking, experts say an association is plausible.

“Obese women often have irregular or no periods because they are not ovulating. Once they lose weight, ovulation becomes more regular and that’s how their fertility improves,” said Dr Karin Hammarberg from Monash University in Australia.

Research is underway to determine whether semaglutide could help stimulate ovulation in women with obesity and polycystic ovary syndrome (PCOS), a condition that can cause irregular periods, weight gain and infertility , among other symptoms.

However, concerns have been raised about the safety of pregnant women using GLP-1 receptor agonists.

A spokesperson for Novo Nordisk, the company that makes Ozempic and Wegovy, said: “Pregnancy or intention to become pregnant were exclusion criteria in our trials with semaglutide in obesity and type 2 diabetes. 2. Therefore, clinical trial data on the use of semaglutide in pregnant women are limited.

Although evidence in humans is insufficient, animal studies suggest that semaglutide may cause fetal abnormalities.

According to Novo Nordisk, when semaglutide was administered to pregnant rats, the unborn offspring showed both structural abnormalities and growth alterations.

Wegovy’s preclinical safety information adds: “In developmental toxicity studies in rabbits and cynomolgus in monkeys, an increase in miscarriages and a slightly increased incidence of fetal abnormalities were observed at clinically relevant exposures.

Although the company is currently conducting trials to determine whether these drugs are safe for pregnant women, it currently advises against using semaglutide during pregnancy because it is not known whether it can affect the fetus.

“Therefore, it is recommended that contraception be used when using this medication,” Wegovy’s patient information leaflet states. “If you want to become pregnant, you should stop using this medicine at least two months in advance. If you become or become pregnant, think you may be pregnant, or plan to have a baby while using this medicine, tell your doctor immediately, as your treatment will need to be stopped.

But some women have reported getting pregnant using GLP-1 receptor agonists despite using hormonal birth control, leading to speculation that the drugs may interfere with these birth control methods.

Professor Sir Stephen O’Rahilly, co-director of the Wellcome-MRC Institute of Metabolic Sciences, said the question of whether GLP-1 receptor agonist drugs can interfere with the effectiveness of oral contraceptives is, until present, largely unanswered.

“People treated with these drugs may develop gastrointestinal side effects, including diarrhea. It is therefore not implausible that some women find that their oral contraceptive pill is not, at least intermittently, absorbed adequately. as reliable as before,” he said.

“A pragmatic response to this situation might be to suggest that for women who are on the pill and wish to avoid pregnancy, while undergoing active weight loss on GLP-1 (receptor agonists), they might consider themselves as being at a level below that of pregnancy. higher risk of pregnancy and use additional methods, such as barrier contraception, until their weight stabilizes, after which it seems likely that contraceptive effectiveness will return to normal.

Hammarberg agreed. “Stories of women on semaglutide becoming pregnant while on the pill are anecdotal accounts and we need to remember that this also happens in women not taking semaglutide. Some think that semaglutide might change the absorption of the pill, but to my knowledge there is no evidence that this is the case,” she said.

“To be doubly sure that an unplanned pregnancy does not occur, it may be wise for women taking Ozempic and similar medications to use condoms and, of course, an IUD would also be a very safe option.”