By Ana Espino | Published on June 08, 2026 | 4 min read
Polycystic ovary syndrome (PCOS) is one of the most common
endocrine disorders affecting women of reproductive age. Affecting
approximately 12% of women worldwide, it is characterized by a variable
combination of hyperandrogenism, ovulatory dysfunction, and metabolic
abnormalities. Obesity and insulin resistance, which are frequently associated
with PCOS, worsen reproductive symptoms and increase the risk of type 2
diabetes, cardiovascular disease, and non-alcoholic fatty liver disease.
Given the limitations of conventional management strategies,
which primarily rely on lifestyle modifications and metformin, GLP-1
receptor agonists (GLP-1 RAs)—already widely used for the treatment of
diabetes and obesity—have attracted growing interest. A systematic review
published in 2025 evaluated the available evidence to assess their impact on
the metabolic and reproductive outcomes of women with PCOS.
Much More Than an Anti-Obesity Treatment
The authors reviewed clinical trials published between 2000
and 2024 involving several GLP-1 receptor agonists, including liraglutide,
semaglutide, exenatide, and dulaglutide. The studies mainly included
overweight or obese women with PCOS who were followed for at least 12 weeks.
The findings consistently demonstrated significant
reductions in body weight, typically ranging from 5 to 10 kg, depending
on the drug and treatment protocol. Semaglutide appeared particularly
promising, with some studies reporting weight losses exceeding 11 kg after
six months of treatment. GLP-1 receptor agonists were also associated with
reductions in visceral adipose tissue, which plays a major role in the
metabolic complications of PCOS.
Beyond weight loss, several studies reported improvements in
insulin sensitivity, reductions in chronic low-grade inflammation,
and better glycemic control. Some evidence also suggested a reduction in
hepatic steatosis and improvements in various cardiometabolic markers.
Read next : Obesity and heart failure: weight loss may restore heart muscle contractility
Potential Benefits for Fertility and Hormonal Function
One of the most intriguing findings concerns the
reproductive benefits observed in some patients. Several trials reported
improvements in menstrual regularity, increased ovulation rates,
and reductions in markers of hyperandrogenism, particularly the free
androgen index.
Some studies also suggested higher rates of both spontaneous
and in vitro fertilization (IVF)-assisted pregnancies. In obese women
experiencing PCOS-related infertility, the combination of liraglutide and
metformin resulted in higher pregnancy rates than metformin alone.
The mechanisms involved may extend beyond simple weight
reduction. The authors highlight improvements in insulin resistance,
reductions in hyperandrogenism, anti-inflammatory effects, and a
potential influence on the hypothalamic–pituitary–ovarian axis. Since
GLP-1 receptors have been identified within ovarian tissue, a direct effect on
ovarian function is also considered possible.
Read next : TyG Index: a new ally against PCOS?
A Promising Strategy That Still Requires Confirmation
Despite these encouraging findings, the authors emphasize
several important limitations. Most available studies were relatively short,
with follow-up periods generally limited to six to eight months. Sample
sizes were often modest, and study protocols varied considerably in terms of
treatment regimens and dosages.
Furthermore, as observed in trials involving obese patients,
partial weight regain frequently occurred after treatment
discontinuation. Data regarding long-term effects on fertility, pregnancy
outcomes, and safety in women attempting to conceive remain limited.
Nevertheless, this review supports the view that GLP-1
receptor agonists may represent a particularly valuable therapeutic option for
women with PCOS who are overweight or obese. By simultaneously improving
body weight, glucose metabolism, and certain reproductive parameters, these
therapies could significantly reshape the management of this complex condition.
Larger randomized controlled trials will, however, be necessary to better
define their role in future clinical guidelines.
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions. 
