GLP-1 medications such as semaglutide, liraglutide, and exenatide have become well known for their roles in diabetes and weight management.
But researchers are increasingly interested in another potential application: Polyendocrine Metabolic Ovarian Syndrome (PMOS), formerly known as PCOS.
That connection makes sense when you consider the metabolic side of PMOS.
Insulin resistance is common in PMOS and can contribute to elevated insulin levels, changes in androgen production, and reproductive dysfunction.⁶ Weight management can also be more challenging for some women with PMOS.
GLP-1 receptor agonists act similarly to the naturally occurring hormone glucagon-like peptide-1 (GLP-1). Among their effects, they can help regulate blood glucose, slow gastric emptying, influence appetite, and improve satiety.
So could these medications address some of the metabolic features that make PMOS so complex?
Recent research suggests they may.
Weight management is where we currently have some of the strongest evidence.
A 2026 systematic review and meta-analysis of 11 randomized controlled trials found that GLP-1 receptor agonists were associated with modest short-term reductions in BMI among women with PCOS and overweight or obesity.²
Another recent meta-analysis found significant reductions in body weight, BMI, waist circumference, waist-to-hip ratio, and abdominal girth compared with metformin or placebo.³
This is particularly interesting because current international PMOS guidelines already recognize medications including liraglutide and semaglutide as options that may be considered alongside active lifestyle intervention for managing higher weight in adults with PMOS.¹
But weight is only one part of the picture.
Because insulin resistance can play such an important role in PMOS, researchers are also asking whether GLP-1 medications could improve the way the body responds to insulin.
A 2026 meta-analysis of randomized controlled trials found that GLP-1 medications significantly improved insulin resistance, alongside reductions in BMI. The researchers found moderate-certainty evidence for both outcomes.⁴
However, not every analysis has reached the same conclusion. Another rigorous 2026 review found that available evidence was not yet sufficient to establish a clear effect on glucose and insulin outcomes.²
Taken together, the metabolic findings are encouraging and give researchers a strong reason to continue investigating GLP-1s specifically for PMOS.
This is where things get especially interesting.
Metabolism and reproductive hormones aren’t separate systems in PMOS. Elevated insulin can interact with ovarian androgen production and influence the hormonal environment involved in ovulation.⁶
That raises the possibility that improving metabolic health could have effects beyond blood sugar or body weight.
A 2024 meta-analysis of randomized controlled trials in women with PCOS and obesity found that GLP-1 medications significantly reduced total testosterone, alongside reductions in BMI, waist circumference, and triglycerides.⁵
Earlier research has also reported improvements in menstrual regularity among women receiving GLP-1 medications. A systematic review and meta-analysis of 11 randomized controlled trials found improvements in menstrual cyclicity as well as natural pregnancy rates.⁷
However, the newest rigorous review concluded that evidence isn’t yet strong enough to establish effects on menstrual regularity or other reproductive outcomes.²
So while GLP-1s aren’t currently considered a direct treatment for irregular periods or infertility, their potential reproductive effects are an exciting area of ongoing PMOS research.
This question deserves special attention because GLP-1 medications should not be used during pregnancy.
Some research suggests treatment before conception could potentially have reproductive benefits. The 2023 meta-analysis found a higher natural pregnancy rate among women receiving GLP-1 receptor agonists.⁷
But that doesn’t mean GLP-1s are fertility medications.
Current international guidelines recommend effective contraception while taking a GLP-1 receptor agonist when pregnancy is possible, because pregnancy safety data are lacking.¹
Anyone who is taking a GLP-1 and thinking about becoming pregnant should work with their healthcare provider on an appropriate treatment and discontinuation plan.
Not necessarily. They serve different purposes, and the best option depends on the individual.
Metformin remains one of the most established medications for managing metabolic features of PMOS and has decades of clinical experience behind it.¹
GLP-1 medications offer another potential tool, particularly for people who have higher weight or metabolic concerns.
Recent head-to-head research is also encouraging. A 2026 systematic review comparing GLP-1 receptor agonists with metformin reported favorable effects on several metabolic and hormonal markers, although the authors emphasized the need for larger and longer randomized trials.
Future research may help us better understand whether GLP-1s work best alone, alongside metformin, or for particular PMOS presentations.
Like any medication, GLP-1 receptor agonists have potential downsides.
Gastrointestinal symptoms, including nausea and abdominal discomfort, are among the most commonly reported side effects. Gradually increasing the dose can help improve tolerability.¹,²
There’s also the question of what happens when treatment stops. International guidelines recommend discussing the potential need for long-term treatment, since weight regain can occur following discontinuation.¹
And because pregnancy safety data are lacking, contraception and future pregnancy plans should be part of the conversation before starting treatment.
For some women, they may.
The latest research is building a promising picture of GLP-1 medications as another potential tool for addressing the metabolic side of PMOS.
The clearest evidence currently points toward improvements in body weight, BMI, and waist circumference, particularly among women with PMOS who have overweight or obesity.²⁻⁵ Research into insulin resistance, testosterone, menstrual regularity, and reproductive outcomes suggests there may be additional benefits worth exploring.
Most importantly, this research reflects how our understanding of PMOS continues to evolve.
PMOS isn’t simply an ovarian or reproductive condition. Metabolism, insulin, hormones, and reproductive function are deeply interconnected. GLP-1 medications give researchers another way to investigate those connections and, potentially, another option for creating more individualized PMOS care.
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