The Efficacy of Birth Control While Using Glucagon-Like Peptide-1 Receptor Agonists

Glucagon-like peptide-1 (GLP-1) receptor agonists, a class of medications used to treat type 2 diabetes and obesity, have seen a significant surge in usage in recent years. However, these drugs may potentially impact the effectiveness of oral contraceptives, leading to concerns about unintended pregnancies[1][4].

Interactions with Oral Contraceptives

GLP-1 receptor agonists, such as Ozempic, Wegovy, and Mounjaro, have been shown to interact with oral contraceptives. These medications may reduce the absorption and effectiveness of birth control pills at specific points in the dosing schedule[1][2].

Eli Lilly’s Mounjaro and Zepbound, which contain the same active compound, explicitly advise healthcare providers to counsel females using oral contraceptives to switch to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation[1].

Potential Impact on Absorption

The impact of GLP-1 receptor agonists on the absorption of oral hormonal contraceptives varies among the different drugs in this class. Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, has been suggested to have a greater impact on oral contraceptive absorption compared to other GLP-1 receptor agonists, potentially due to its rapid dose escalation and effects on gastric emptying[2].

Recommendations for Women Using GLP-1 Receptor Agonists

Women considering GLP-1 receptor agonist treatment while using oral contraceptives are encouraged to plan ahead to avoid unintended pregnancies. Having a contraceptive strategy and the appropriate product on hand enables spontaneous intimacy regardless of where they are in their GLP-1 dosing schedule[1].

An on-demand, hormone-free method, such as Phexxi, is a prudent choice to provide these patients with the additional protection they require[1]. Healthcare providers should inform patients about the potential interactions between GLP-1 receptor agonists and oral contraceptives, providing them with alternative methods of contraception if necessary.

Conclusion

The increasing popularity of GLP-1 receptor agonists among women seeking weight loss has raised concerns about their potential impact on the efficacy of oral contraceptives. While the interactions vary among the different drugs in this class, it is essential for healthcare providers to counsel patients on the importance of using alternative contraceptive methods or adding barrier protection when initiating or escalating GLP-1 receptor agonist therapy. By understanding these interactions and taking appropriate precautions, women can make informed decisions about their reproductive health while using these medications.

Citations:

[1] https://finance.yahoo.com/news/women-using-glp-1-receptor-125400133.html

[2] https://www.sciencedirect.com/science/article/pii/S1544319123003709

[3] https://my.clevelandclinic.org/health/articles/11427-birth-control-options

[4] https://www.uptodate.com/contents/glucagon-like-peptide-1-based-therapies-for-the-treatment-of-type-2-diabetes-mellitus

[5] https://www.ncbi.nlm.nih.gov/books/NBK551568/