Researchers warn that widespread use of weight-loss drugs like Ozempic among women of reproductive age may pose hidden risks to pregnancy.
Flinders University researchers caution that many women using popular weight-loss medicines during their reproductive years may not be aware of potential risks to pregnancy and fetal development.
A new study reports that most Australian women of reproductive age who are prescribed GLP-1 receptor agonists are not using effective contraception, despite known risks during pregnancy. These medicines, including Ozempic, are increasingly taken for weight loss.
Published in the Medical Journal of Australia, the research examined records from more than 1.6 million women aged 18 to 49 who attended general practices between 2011 and 2022. Among the 18,010 women who began GLP-1 receptor agonist therapy during that period, only 21% reported using contraception.
GLP-1 receptor agonists were developed to treat type 2 diabetes but have become widely used for appetite control and weight loss. The study also found that most prescriptions are now written for women without diabetes.
Rising Prescriptions Among Non-Diabetic Women
Lead author and pharmacist, Associate Professor Luke Grzeskowiak, says that in 2022 alone, more than 6,000 women began treatment on GLP-1s, and over 90% of those did not have a diabetes diagnosis.
“We’re seeing widespread use of these medications among women of childbearing age, but very little evidence that contraception is being considered as part of routine care,” says Associate Professor Grzeskowiak from the College of Medicine and Public Health.
“These medications can be incredibly helpful, but they’re not risk-free, especially during pregnancy.”
The study found that 2.2% of women became pregnant within six months of starting GLP-1 treatment, with pregnancy rates highest among younger women with diabetes, and among women without diabetes in their early thirties.
Women with polycystic ovary syndrome were twice as likely to conceive, suggesting that weight loss may improve fertility, even when unintended.
Importantly, women who were using contraception at the time of prescribing had a significantly lower risk of pregnancy.
Evidence From Previous Research
A previous review of animal studies from the University of Amsterdam linked GLP-1 exposure during pregnancy to reduced fetal growth and skeletal abnormalities, and while human data is limited, the potential risks remain concerning.
“Whilst the UK advises that women using GLP-1 receptor agonists should avoid pregnancy and use effective contraception, this advice is not being followed consistently in Australian clinical practice,” says Associate Professor Grzeskowiak.
“We need to ensure that reproductive health is part of every conversation when these drugs are prescribed to any woman of childbearing age.
“It is also vitally important that we have clearer practice recommendations and guidelines for those prescribing GLP-1s to women to ensure their safe and effective use.
“Our advice is to speak to your GP about the risks and benefits of GLP-1 medicines before taking them, and only take those prescribed by a healthcare professional.”
The authors say that further studies evaluating the impact of these medications on pregnancy and unborn babies are warranted.
Reference: “Incidence of GLP-1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011–2022: a retrospective open cohort study” by Kailash Thapaliya, Arianne Sweeting, Black I Kirsten, Amanda Poprzeczny, Danielle Mazza and Luke E Grzeskowiak, 1 September 2025, Medical Journal of Australia.
DOI: 10.5694/mja2.70026
Luke Grzeskowiak receives salary support from a Channel 7 Children’s Research Foundation Fellowship (CRF-210323). We also acknowledge the contributions of members of the SPHERE Centre of Research Excellence in Women’s Sexual and Reproductive Health in Primary Care (SPHERE 2.0 CRE), which is funded by the National Health and Medical Research Council (APP2024717).
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