Australian Study Highlights Potential Link Between GLP-1 Medications and Unplanned Pregnancies
Table of Contents
A new Australian study underscores the critical need for physicians to proactively discuss reproductive health with women prescribed glucagon-like peptide-1 (GLP-1) receptor agonists, revealing a potential connection between these medications and an increased risk of unintended pregnancies.
Researchers are warning that many women initiating GLP-1 therapy may be unaware of the associated risks of unplanned pregnancy, as well as potential fetal risks linked to the medications. the findings, stemming from an analysis of over 1.6 million women, have prompted calls for a more comprehensive approach to patient counseling.
The research, conducted by Flinders University, analyzed data from women aged 18-49 who attended general practices between 2011 and 2022. The analysis revealed that among the 18,010 women first prescribed GLP-1 medications during this period, a surprisingly low 21% reported consistent contraceptive use. furthermore,2.2% of these women became pregnant within six months of starting GLP-1 treatment.
“These findings serve as a good reminder for GPs to routinely discuss reproductive health plans with women wanting GLP-1 therapy,” stated Dr. Ka-Kiu Cheung, Chair of RACGP specific Interests Antenatal and Postnatal Care. “With the increasing use of GLP-1 receptor agonists for type 2 diabetes and weight management, it is notable that GPs actively address reproductive health considerations in women of child-bearing age.”
Rising Prescriptions, Primarily for Weight Loss
The prescribing of GLP-1 receptor agonists to women of reproductive age is on the rise in Australia, with a significant majority of prescriptions now being written for individuals not diagnosed with type 2 diabetes.In 2022,of the 6,954 women newly prescribed a GLP-1 receptor agonist,90.5% did not have type 2 diabetes, indicating a ample increase in off-label use for weight loss.
Popular medications in this class, such as semaglutide (marketed as ozempic and Wegovy) and the dual GIP/GLP-1 agonist tirzepatide (Mounjaro), have gained considerable popularity for their weight loss effects in both men and women.Australia’s Therapeutic goods Administration (TGA) has approved semaglutide for chronic weight management.
Dr. south highlighted encouraging findings from preliminary data suggesting that accidental pregnancies occurring with lower doses of semaglutide (Ozempic) have not resulted in significant teratogenic effects in babies. Though, she emphasized the need for further research, notably regarding the potential epigenetic effects of these medications on both sperm and egg advancement. “I do feel that we need more data about the use of these medications in the epigenetic influence on the development of sperm and egg, which is perhaps happening three months before that egg is actually conceived,” she said.
Recommendations for Clinical Practice
Both Dr. South and Dr. Cheung strongly advocate for GPs to proactively discuss family planning with women of child-bearing age undergoing GLP-1 treatment. Dr. Cheung advises clinicians to “proactively discuss contraception when initiating GLP-1 therapies in women of child-bearing age, document pregnancy intentions, and give pre-conception wash-out advice as per FSRH guidelines.”
Dr. South echoed this sentiment,stating,”GPs need to understand that,yes,the medication is contraindicated in pregnancy. Thus, they need to know what their patient’s contraception current use is, and in the context of family planning as well. and if there is family planning, that the medication should be stopped at least two months prior to removing contraception or trying to conceive.”
These medications can be incredibly helpful, but they’re not risk-free, especially during pregnancy.
