2026-05-12

GLP-1 Agonists Are Changing OBGYN Practice. Here's What the Paper Says.

Your gynecologist is seeing GLP-1 patients now. PCOS patients. Pregnant patients who didn't stop in time. Surgical patients who delayed gastric emptying. The drugs crossed into women's health faster than the guidelines did.

What we know. Chauhan's review in Current Opinion in Obstetrics & Gynecology (May 2026) synthesizes the evidence: 15–21% body weight reduction in Phase 3 trials. Tirzepatide beats semaglutide. In women with PCOS, meta-analyses confirm better insulin resistance, lower androgens, more ovulation. Real benefits.

The contraception problem. Tirzepatide delays gastric emptying. That means oral contraceptives may not absorb properly. Eli Lilly now recommends backup contraception for four weeks after starting or increasing dose. The paper flags this explicitly — the manufacturer changed guidance because the mechanism matters.

Pregnancy exposure. Animal studies showed teratogenicity. Human data is starting to arrive. Emerging cohort studies of inadvertent early pregnancy exposure report no increased risk of major congenital malformations. Preliminary reassurance, not certainty. The paper calls for pregnancy registries. They don't exist yet.

Surgery. Old guidance said stop before surgery, period. New approach: risk-stratified, individualized. Not every patient needs the same discontinuation window. The paper doesn't give you a protocol — it tells you the blanket rule is gone.

What's missing. Long-term pregnancy registries. Dosing studies in PCOS. Clearer perioperative timelines by drug and dose. The review is honest about the gaps.

If you're using GLP-1 and seeing an OBGYN. Tell them. Tell them which one, what dose, when you started. If you're on oral contraception, ask about backup. If you're planning pregnancy, ask when to stop — the data says stop, but not exactly when.

The drugs moved faster than the research. Your doctor is reading the same incomplete map you are.