As GLP-1 medications become increasingly common for weight management and diabetes care, questions about reproductive health have followed. GLP-1 contraception counseling is an important part of treatment planning, especially for patients of childbearing potential.
Practitioners on Healthcasts shared how they approach these discussions, including which contraceptive options they recommend and how they manage increased fertility risks associated with weight loss.
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Key takeaways about GLP-1 contraception counseling:
Family Practice
"1. Tirzepatide can reduce the bioavailability of oral contraceptive pills, so I recommend a barrier method for 4 weeks after initiation or dose change, or switch the patient to non-oral contraceptive options.
For those with PCOS and others, you need to discuss their end goal for pregnancy. There is a risk of increased fertility while on the GLP-1 due to weight loss. Discuss that you do not want them to become pregnant while on the GLP-1, so offer appropriate non-oral contraceptive options such as IUD, ring, patch, injection, or implant. However, once weight is lost, they can try to conceive after a wash-out period from GLP-1."
Family Practice
"I tell them that their OCPs may lose efficacy. If they want to continue OCPs and do not desire pregnancy, then they need a backup form, such as a condom, every time they engage in sex. Otherwise, if possible, I recommend an IUD or Nexplanon, as they are the most efficacious. If the patient desires pregnancy within the next year or two, then I favor NuvaRing or Nexplanon over IUD, as IUD is painful to insert for many women."
Family Practice
"Specifically for Mounjaro, it is recommended to use non-oral methods for contraception for the first four weeks of initiation of treatment and for four weeks with any dose increase due to the gastric emptying delay. Usually, this delay is less pronounced as you continue to use the medication. If a non-oral contraception is not ideal, then they should use a barrier method for those four weeks."
Family Practice
"They need pre-conception planning. Ideally, it's recommended to stop the GLP-1 at least 1 month before conception. They also need to have regular ultrasound/ prenatal check-ups to check for teratogenic effects with the medications."
Internal Medicine
"I inform them of the possibility of increased fertility with weight loss and that they should not get pregnant on these medications. If they are not on a contraceptive, we start one, and if they are using oral birth control, then they should use a barrier method as well to prevent pregnancy."
Would you recommend a barrier method, IUD, or something else? Review the full case on Healthcasts and share your suggestion.