GLP-1s in Perimenopause and Menopause
Insights For A Woman in Transition Who Is Interested in Making Informed Decisions
This article is for educational purposes only, and should not be used in place of an actual doctor's visit. If you’d like personalized guidance, I’d be honored to connect in an Introductory Call.
There she was on Zoom, a new client in a coaching session with me, both frustrated and hopeful. “I’m not eating as much anymore, but I’m still exhausted. I’m still having hot flashes. I’m sleeping poorly.” She had started a GLP-1 medication to help with the stubborn weight gain that had crept in during perimenopause. It was working—she was eating less, her appetite had dropped, and the scale had moved. But something else was happening too.
Her nutrient intake had plummeted. Her protein was low. She wasn’t getting enough fiber, magnesium, or omega-3s—nutrients that directly support hormone balance, mood, sleep, and metabolic health.
That initial coaching conversation stayed with me because it was the latest in a string of similar conversations with many of my clients these days.
It was the moment I realized this story—the story of so many midlife women—wasn’t just about weight. It was about nourishment. About navigating new medical tools in a body that’s changing because of perimenopause and menopause. About making choices not from pressure or panic, but from clarity.
This article is for her. And for you, if you’re wondering whether GLP-1 medications could be part of your midlife support plan.
Everywhere you turn lately, someone is talking about Ozempic, Wegovy, Mounjaro, or Zepbound. Celebrities, influencers, even your neighbor. And if you're a woman in your 40s, 50s, or 60s who has been experiencing the very real metabolic shifts of perimenopause or post-menopause, it's natural to wonder: Could this help me?
The short answer? Maybe.
I have many coaching specialties. As a functional medicine certified health coach who specializes in midlife wellness, I'm not here to prescribe or promise. I’m not a doctor. I'm here to help you ask the right questions, understand the science, and make informed choices about your body and your journey. I’m writing this so that you can have informed conversations with your health provider(s) about a path that’s right for you.
In this article, I'll walk you through what GLP-1 medications are, what the latest research says, what makes them unique for women in midlife, and share some real-life stories from women just like you.
What Are GLP-1 Medications?
GLP-1 agonists are a class of medications originally developed to help manage type 2 diabetes. Drugs like Ozempic (semaglutide), Wegovy (semaglutide at a higher dose), and Mounjaro (tirzepatide) mimic a hormone your body already makes: GLP-1 (glucagon-like peptide-1). This hormone helps regulate blood sugar, slows down digestion, increases satiety, and suppresses appetite.
While they were initially used for diabetes, several of these medications are now FDA-approved for weight management in people with obesity or overweight conditions. They work by helping people feel full faster and longer, which can reduce overeating and support weight loss.
Why Midlife Women Are Asking About GLP-1s
Perimenopause and menopause bring major hormonal shifts that directly affect metabolic health. As estrogen declines, women may experience:
Increased insulin resistance
Greater accumulation of visceral fat (especially around the belly)
Slower digestion
More intense food cravings
GLP-1s may help mitigate some of these issues. Studies like the STEP 1 Trial and SELECT Trial have shown that semaglutide supports significant weight loss and may reduce cardiovascular risk in people with obesity.
But it’s not just about the scale. For many midlife women, it’s about regaining a sense of vitality and agency over their bodies in a season of life that can feel chaotic.
Real Women, Real Journeys
Meet Dana, 52
Dana entered menopause at 49 and noticed her weight creeping up despite consistent workouts and clean eating. Her fasting glucose was edging toward prediabetes. After working with her doctor, she started semaglutide. Over 6 months, she lost 12% of her body weight, gained better blood sugar control, and reported fewer sugar cravings. As her coach I suggested she keep track of her protein intake and add strength training to prevent muscle loss. Both suggestions are very important if you’re taking a GLP-1 medication.
Meet Renee, 47
Still in perimenopause, Renee struggled with intense PMS, bloating, and an extra 20 pounds she couldn’t shake. She and her provider used GLP-1 medication for 16 weeks with slow titration. While she lost 15 pounds, the biggest shift was emotional: "I finally felt like food didn’t control me anymore," she shared. Our coaching sessions centered around emotional wellness since the health struggle had taken its emotional toll. She used journaling to explore emotional eating, a possible thread in her story.
Meet Linda, 61
Postmenopausal and recently diagnosed with type 2 diabetes, Linda wanted a non-insulin option. Her doctor prescribed tirzepatide. With nutritional coaching, mindful movement, and medication, her A1C dropped significantly and she lost 20 pounds over the course of a year. A multi-prong approach is usually the way to go.
Meet Monique, 55
Monique had a history of yo-yo dieting and disordered eating. She was hesitant about GLP-1s but curious. With a supportive medical team and coaching with me, she decided to try it. What worked for her was going slowly, focusing on inner work, and combining her journey with body image coaching. "It’s not just about weight for me anymore," she says. "It’s about peace." This was her breakthrough.
What the Research Says
Weight loss: GLP-1 medications can help people lose between 10-15% of body weight on average over 68 weeks (NEJM, 2021).
Cardiovascular health: The SELECT trial showed semaglutide reduced heart attack and stroke risk in high-risk individuals (NEJM, 2023).
Long-term use: Some people regain weight after stopping. A 2022 study found participants regained two-thirds of their lost weight a year after stopping semaglutide.
Side effects: Common ones include nausea, constipation, fatigue, and delayed stomach emptying. Rare but serious risks include pancreatitis and gallbladder issues (Cleveland Clinic).
Concerns for midlife women: Loss of lean muscle and bone mass is a risk with rapid weight loss, especially during and after menopause. Strength training and protein intake are essential.
Should You Consider GLP-1s?
Only you and your doctor can decide. But here are a few questions to help guide your conversation:
What are my metabolic markers right now (glucose, A1C, cholesterol)?
Have I tried lifestyle changes and hit a plateau?
Do I have a history of disordered eating or body image issues?
Am I willing and able to combine this with long-term behavior and mindset changes?
GLP-1s are not magic. But they can be a tool—especially for women who feel like they’ve been doing "everything right" and are still stuck.
A Closing Thought
As you explore your options, I invite you to pause and ask: What does true support look like for me right now? Is it weight loss? Energy? Better sleep? More ease with food? Or something deeper—like feeling fully nourished, seen, and strong in this season of change?
GLP-1s may be a helpful tool. But they’re not the full picture. Midlife asks for more than medication—it asks for self-leadership, wholeness, and sometimes, a complete rewrite of what health means to you.
So, if you’re navigating this path—curious, cautious, or somewhere in between—you don’t have to go it alone. I wrote a Guide for you.
My GLP-1 Guide for Women in Midlife allows you to dive deeper. It’s packed with evidence, reflections, and questions to help you have a meaningful, informed conversation with your doctor.
And of course, you can always https://hub.beingwellaware.com/shop/introductory-call-with-carla-moss with me for a more personal conversation about your next steps on this journey. Whatever you choose, let it be rooted in self-trust—not fear. You deserve care that honors the woman you are and the one you're still becoming.