Ozempic side effects in females

In this article:

• Common side effects
• Long term side effects
• Manage and prevent side effects

In this article

• Common side effects
• Long term side effects
• Manage and prevent side effects

Ozempic (semaglutide) is an injectable medication approved by the U.S. Food and Drug Administration (FDA) to treat Type 2 diabetes mellitus and lower the risk of heart attack or stroke in people with Type 2 diabetes and cardiovascular disease. Healthcare providers may also use Ozempic injectables off-label for weight loss management. It falls under the drug classes of antidiabetics and GLP-1 agonists . Like any other prescription or over-the-counter medication, Ozempic may cause unwanted side effects, which may vary by gender.

What are common Ozempic side effects in females?

Pamela Tambini, MD, a double board-certified physician in internal medicine and addiction medicine and the Medical Director at Engage Wellness in Acton, Massachusetts, says that while Ozempic works the same in men and women, some women may experience certain side effects more frequently than men. “Nausea, vomiting, and gastrointestinal discomfort are reported more often by female patients,” she explains. “Additionally, because Ozempic can cause significant weight loss, it may indirectly affect hormone levels, menstrual cycles, or even fertility in women. While the differences aren’t extreme, women might want to consider these factors and discuss any concerns with their healthcare provider.”

The most common side effects of Ozempic include gastrointestinal symptoms like:

• Nausea
• Vomiting
• Diarrhea 
• Constipation
• Abdominal pain
• Stomach pain
• Eructation (belching or burping)
• Decreased appetite
• Dyspepsia (indigestion)
• Abdominal distension
• Flatulence (gas)
• Gastritis (stomach lining inflammation)
• Increased amylase
• Increased lipase

“These usually happen when someone first starts the medication or increases their dose,” Dr. Tambini explains. “These symptoms occur because Ozempic slows down digestion, which can irritate the stomach.”

Other common symptoms unrelated to the digestive system include:

• Diabetic retinopathy
• Hypoglycemia (low blood sugar) when combined with other diabetes medication
• Injection site reactions

Dr. Tambini also says that some women who take Ozempic may report symptoms like fatigue, headaches, and, in rare cases, hair thinning.

If any of these side effects are causing you significant distress, please reach out to your healthcare provider. 

Ozempic and pregnancy

According to Afia Naqvi, MD, a triple board-certified physician in internal medicine, aesthetic medicine, and regenerative medicine, and the owner of Renove Medical Spa in Kingwood, Texas, it’s currently unknown whether the injectable medicine can be harmful to a developing fetus. “It’s still unknown whether Ozempic can harm an unborn baby or be transmitted through breast milk, so the manufacturer recommends stopping use two months before planning to become pregnant,” she explains. “Those who are already pregnant should talk to their healthcare provider for guidance.”

The FDA says that because of limited data, they don’t recommend the use of Ozempic during pregnancy. They also refer to animal studies that revealed GLP1-agonists were associated with reduced fetal weight and/or growth, delayed bone formation, lower maternal weight gain, and decreased food consumption.

A patient’s healthcare team of doctors may discuss alternatives to Ozempic to take while pregnant. 

Ozempic while breastfeeding

Dr. Tambini says there’s insufficient research supporting the use of Ozempic while breastfeeding. “It’s unclear if the medication passes into breast milk or if it could affect a nursing baby,” she explains.

Fortunately, there are safer alternatives to Ozempic while breastfeeding or lactating. “Traditional medications like insulin and metformin have been studied extensively and deemed safe for use while breastfeeding,” Dr. Naqvi says. “While the drugs Saxenda (liraglutide) and Trulicity (dulaglutide) have been posed as possible alternatives to Ozempic, the medical community hasn’t officially deemed any GLP-1 agonist medication definitively safe for use while breastfeeding.” Decisions on which medications to use while breastfeeding must be made on an individual basis in consultation with one’s medical providers.

In addition to discussing medications, Dr. Tambini recommends adopting a balanced diet, engaging in regular exercise, and staying hydrated to continue controlling diabetes and supporting a healthy weight while breastfeeding or lactating. She also recommends speaking with your healthcare provider to create a plan that works for you and your growing baby.

Ozempic during menopause

Research reveals that a large portion of women going through menopause report weight gain between 2 to 4 pounds per year despite no changes in their eating habits or level of physical activity. Because of this symptom, it could be assumed that Ozempic or other GLP-1 drugs could be prescribed for weight loss management from menopause.

However, Dr. Tambini says this drug is not approved for managing symptoms of menopause. “While it might help with weight management, which is a common concern during menopause, it doesn’t address other symptoms like hot flashes, mood swings, or reduced bone density,” she says. “Treatments like hormone replacement therapy (HRT) are still the gold standard for menopause-related issues. If weight gain or insulin resistance is part of your menopause journey, Ozempic might indirectly help in those areas.”

Should women be concerned about long-term side effects of Ozempic?

Dr. Tambini says that the long-term side effects of Ozempic are still being studied but lists the following as potential complications of taking this injectable medicine for an extended period:

• Persistent nausea
• Gastrointestinal discomfort
• Gallbladder issues
• Increased risk of pancreatitis

“There’s also an ongoing investigation into whether prolonged use might increase the risk of thyroid tumors,” Dr. Tambini explains. “However, this has primarily been observed in animal studies and hasn’t been confirmed in humans. Women with a personal or family history of thyroid cancer or gallbladder disease should be especially cautious.” The FDA warning regarding a history of thyroid cancer applies specifically to the rare medullary or C-cell form, which can be part of Multiple Endocrine Neoplasia type 2 syndrome.

She adds that these potential risks shouldn’t deter you from using Ozempic if your healthcare provider deems it medically necessary and safe. Still, it’s crucial to get regular check-ups and share any concerns you have with them.

How can women manage or prevent side effects of Ozempic effectively?

The recommended starting dose for Ozempic is 0.25 milligrams (mg) once a week for the first four weeks. This can then be increased to the standard dose of 0.5 mg once weekly for month two. The maximum Ozempic dose is 2 mg once per week at month four and beyond. It’s best to gradually increase your dosage to help your body adjust to the medication and lower your risk of side effects. 

Other ways you can reduce your chances of experiencing adverse effects of Ozempic include:

• Gradually increasing dose: “Start low and go slow—that’s the golden rule with Ozempic,” Dr. Tambini advises. “Beginning with a lower dose and gradually increasing it can help your body adjust more comfortably.”
• Staying hydrated: “Staying hydrated is crucial—especially when dealing with diarrhea or vomiting,” Dr. Tambini says. 
• Eating foods that support digestive health: “Fatty, greasy foods can worsen nausea and diarrhea, while fiber-rich foods can help with bowel regularity,” Dr. Naqvi says.

According to Dr. Naqvi, certain drug-drug interactions could increase the risk of semaglutide side effects. “Diabetes medications like insulin and metformin, as well as some oral medications, beta-blockers, statins, anticoagulants, anticonvulsant medications, and certain antibiotics and antimalarial drugs, can all interact negatively with Ozempic, including causing dangerously low blood sugar, decreasing the effectiveness of other drugs, and making Ozempic side effects more likely to occur,” she explains.

Dr. Tambini also adds that if you’re on hormonal birth control, you should check with your healthcare provider to ensure your contraception is still working normally. 

While there’s evidence that Ozempic does not impact some oral contraceptive levels, the active ingredient in this drug, semaglutide, could possibly affect the absorption of oral contraceptives. 

Other medications that are known to interact with Ozempic include:

• Sulfonylureas
• Insulins
• Levothyroxine

Potential food-drug interactions of Ozempic include:

• Spicy, fried, and greasy foods, such as pizza, fries, and potatoes
• Sugary drinks and food
• Processed foods
• Cruciferous vegetables
• Alcohol 

Ozempic interactions with health conditions to take note of include:

• Medullary thyroid carcinoma (MTC)
• Pancreatitis
• Diabetic retinopathy

“Establishing a comprehensive medical history with a medical provider can help reduce the risk of interactions and negative side effects,” Dr. Nagvi says.

Before starting, changing, or discontinuing Ozempic, consult with your healthcare provider to learn about any potential side effects and receive instructions on how to slowly taper off the medication if necessary.