As weight-loss medications like Ozempic and Wegovy become more popular, many women are using them to manage diabetes, PCOS, and obesity. However, the World Health Organization (WHO) has recently highlighted a consideration: these medications may influence the effectiveness of oral contraceptives.

How GLP-1 Medications Impact the Pill

GLP-1 receptor agonists, the class of drugs used in treatments like Ozempic, work by slowing gastric emptying. This helps regulate hunger and stabilize blood sugar, but it can also lead to common side effects like nausea, vomiting, diarrhea, and bloating. Since oral contraceptives are absorbed in the digestive system, any disruption in gastric function can affect how well the pill is absorbed, reducing its effectiveness. Even occasional digestive issues — such as nausea or vomiting — can lower the pill’s reliability, increasing the risk of unintended pregnancy.

Key Recommendations from the WHO

To address these concerns, the WHO has provided clear guidelines for women using GLP-1 medications:

1. Switch to Non-Oral Contraceptive Methods

The WHO advises using contraceptive methods that bypass the gastrointestinal system entirely. These include:

• Hormonal IUD (e.g., Mirena)
• Copper IUD
• Contraceptive implant

2. If You Stay on the Pill, Add a Barrier Method

If you prefer oral contraceptives, the WHO recommends using a backup method, such as condoms. This is not because the pill suddenly becomes ineffective, but because its absorption can become less predictable due to the side effects of weight-loss medications.

What Should You Do?

If you’re on a weight-loss medication and rely on the pill, here are a few practical steps:

1. Talk to Your Healthcare Provider

It’s important to discuss both the weight-loss medication you’re using and the contraception you rely on. 

2. Consider Non-Oral Contraception

If you’re open to alternatives, consider switching to long-acting, non-oral methods like an IUD or implant. These methods are reliable, don’t depend on your digestive system, and require less day-to-day attention.

3. If You Stick with the Pill, Use a Backup Method

Adding a barrier method, such as condoms, if you’re taking oral contraception

The WHO’s guidelines are designed to help women make informed choices about contraception while using these drugs, not to cause concern. Whether you decide to switch to non-oral contraception or add a backup method, the goal is to support both your metabolic and reproductive health in a balanced way.

It’s always a good idea to have a chat with your healthcare provider — your health and peace of mind are important.

For more information on IUDs see Dr Kate Stewart’s blog here.

Written by Senior Registrar Gynaecology, Dr Erin Stewart