GLP-1 and HRT Advice  

This information may be useful if you are taking HRT and using a GLP-1.

Both Mounjaro® and Wegovy® belong to a class of medications called GLP-1 receptor agonists. They are highly effective for:

• Reducing appetite
• Helping with blood sugar control
• Supporting significant, sustainable weight loss

One of the ways they work is by slowing down the emptying of your stomach (called delayed gastric emptying). While that’s fantastic for helping you feel fuller for longer, it also means any medication you swallow—including oral HRT tablets—may not absorb properly.

The part of HRT we’re particularly concerned about is oral progesterone (e.g., Utrogestan®).
Progesterone plays a vital role in protecting your womb lining (endometrium) if you’re taking oestrogen. If the progesterone isn’t properly absorbed, your womb lining could build up, putting you at risk of heavy bleeding, abnormal bleeding, or even endometrial cancer.

In short:
Your HRT might stop working properly
You might bleed again after years without a period
You might unknowingly increase your risk of womb problems

The British Menopause Society has issued new interim guidelines specifically for women on Mounjaro®, Wegovy® and other GLP-1 medications.
Here’s what you need to know:

1. You may need to switch your oral oestrogen to a transdermal route

• Instead of taking oestrogen tablets, we can prescribe patches, gels, or sprays applied to the skin.
• These are absorbed directly into the bloodstream, bypassing the digestive system entirely.

2. You may need to switch to a non-oral form of progesterone

3. The best option? A Mirena® coil fitted in the womb.
   It releases progesterone exactly where it’s needed and gives reliable, consistent protection.
4. If you stay on oral progesterone (like Utrogestan®) you may need to temporarily increase your progesterone dose.

• When starting Mounjaro® or Wegovy®—or when the dose increases—we may need to double your oral progesterone dose for 4 weeks.
• This helps ensure your womb remains protected during the crucial period when absorption might be reduced.

Please book an appointment to discuss this – never change your dose without first discussing it with a doctor.

If you’re on HRT and Mounjaro®/Wegovy®, please contact us if you notice any of the following:

• Fresh bleeding after months or years without a period
• Spotting between periods
• Unusual pelvic discomfort or bloating
• Changes in discharge or unusual pain