Hormone therapy for menopause might actually boost the weight-loss benefits of drugs like Ozempic and Zepbound, a new study says.
Middle-aged women taking hormone therapy to manage hot flashes and other symptoms of menopause wound up achieving greater weight loss from GLP-1 drugs, according to research slated for presentation Thursday at the annual meeting of the Menopause Society.
The research involved about 3,900 women, with nearly 2,400 taking semaglutide (Ozempic/Wegovy) and nearly 1,500 taking tirzepatide (Mounjaro/Zepbound), making it one of the largest studies examining the link between GLP-1 drugs and hormone therapy, investigators said.
“We are seeing a consistent signal,” said lead researcher Dr. Regina Castaneda, a postdoctoral fellow with Mayo Clinic Florida.
“Our earlier, smaller studies showed an association between hormone therapy use and greater weight loss in postmenopausal women, and the fact that we see the same signal in a larger, independent cohort should not be overlooked,” she said in a news release.
Researchers followed women taking semaglutide for about 26 months and those taking tirzepatide for about 16, comparing weight loss based on whether they also were on hormone therapy for menopause.
All the women in the study were 45 or older, with an average age of 57, and had a BMI that placed them in the overweight-to-obese category, researchers said. (BMI, or body-mass index, is an estimate of body fat based on height and weight.)
Results showed that hormone therapy and semaglutide taken together produced consistently better weight-loss results.
For example, at one year of follow-up, women taking both hormone therapy and semaglutide had lost about 11 percent of their total body weight on average, versus 9.5 percent for those on semaglutide alone.
Further, more women taking semaglutide and hormone therapy were likely to achieve a greater weight loss goal for themselves.
About 22 percent of women on the combo lost 20 percent or more of their body weight, compared to 18 percent of those on semaglutide alone. Likewise, 6 percent of combo users lost 30 percent or more of their body weight, compared with 4 percent of semaglutide-only patients.
Tirzepatide also produced better benefits when taken with hormone therapy, but not as much as semaglutide — modestly greater weight loss was seen at three months of follow-up (6.6 percent versus 5.9 percent) and a higher proportion achieved 5 percent or more total body weight loss (88 percent versus 84 percent).
“Interestingly, the effect was stronger with semaglutide than with tirzepatide, which deserves further study and may point to an interaction specific to GLP-1 signaling,” Castaneda said.
Semaglutide only contains medication that works on the body’s GLP-1 receptors, while tirzepatide is a dual-action drug that works on two sets of receptors, GIP and GLP-1.
It makes sense that hormone therapy might have this boost effect, “given preclinical data suggesting a potential synergistic effect between estrogen and GLP-1 signaling,” Castaneda said.
RELATED: Thinking About a GLP-1 Weight Loss Clinical Trial? What Black Patients Need to Know
However, more research is needed to prove and better understand this link, she said.
“These findings need to be confirmed in adequately designed prospective trials, and it’s important to remember that weight loss is not an indication for menopause hormone therapy,” Castaneda said.
The Menopause Society noted that middle-aged women commonly experience weight gain resulting from menopause, and have turned to GLP-1 drugs for help. About 1 in 5 women aged 50 to 64 are or have used a GLP-1 medication, more than any other group in the U.S.
“Weight gain and changes in body composition are among the most common and frustrating concerns women experience during the menopause transition,” said Dr. Stephanie Faubion, medical director for The Menopause Society.
“These findings suggest that hormone therapy may influence how some women respond to GLP-1-based weight loss medications,” she said in a news release. “Although more research is needed, this study highlights the importance of considering menopause-specific factors when developing personalized approaches to weight management for midlife women.”
The annual meeting of The Menopause Society runs through Saturday in San Diego.
Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
According to research, obesity affects Black women at higher rates than many other demographic groups. The hormonal changes during menopause can make weight management even more difficult. Declining estrogen and progesterone, along with metabolic changes, can shift fat storage to the abdomen, reduce lean muscle mass, and increase insulin resistance, which are many issues women report during midlife.
Research findings that improve GLP-1 effectiveness could be especially meaningful for women facing multiple weight-related health risks.
RELATED: Why We Need More Black Women in Clinical Trials
This study is just one of many ongoing trials exploring new approaches to managing menopause and its related health challenges.
Researchers are currently studying:
Greater representation in clinical research is critical to better understanding how treatments work across different populations. Historically, Black Americans have been heavily underrepresented in clinical trials, limiting researchers’ ability to fully understand how certain therapies may affect diverse communities.
Today, researchers are increasingly recognizing the need for more diverse participation in studies involving obesity, diabetes, menopause, and cardiovascular disease.
By participating in clinical trials, Black women can help advance research, improve health equity, and contribute to a better understanding of treatments that may benefit future generations.
If you want to learn more about clinical trials, you can visit BlackDoctor’s Clinical Trials Resource Center.
More information
Stanford Medicine has more on GLP-1 drugs.
SOURCE: The Menopause Society, news release, Oct. 20, 2026
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