Glucagon-like Peptide-1 Receptor Agonists and Reproductive Health: Current Evidence and Clinical Implications.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have experienced rapid growth in recent years as treatments for type 2 diabetes mellitus and obesity. These medications offer promising benefits, including weight loss and improved glycemic control; however, their implications for reproductive health warrant attention. While tirzepatide has been shown to impact absorption of oral contraceptives due to delayed gastric emptying, other GLP-1RAs do not appear to have clinically significant interactions with oral contraception. Fertility outcomes may improve with GLP-1RAs and dual GLP-1/GIP agonists due to weight loss and related metabolic benefits. Despite their widespread use, data on GLP-1RAs in pregnancy and lactation remain limited, leaving significant gaps in guidance for clinicians. This review synthesizes current literature on GLP-1RAs to highlight reproductive health considerations, including their potential impacts on contraception, fertility, pregnancy, and lactation. Greater awareness and understanding of these factors can support informed decision-making and optimize care for individuals using GLP-1RAs.