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Wegovy and menopause: everything you need to know

Written by:
Alexandra Mitrutoiu
Alexandra Mitrutoiu,
03 Nov 2026 • 13 min read
Reviewed and fact-checked:
Ayesha Bashir
Ayesha Bashir, Prescribing Pharmacist
Woman on her phone, lounging on the sofa

Menopause can change more than your periods. You may notice changes to your weight or body shape, sometimes without making any obvious changes to what you eat or how active you are. If that feels frustrating or difficult to make sense of, you’re not alone. At least 50% of women gain weight during perimenopause and menopause.

But weight gain during menopause isn’t a sign that you’ve failed or that you’ve done something wrong. And losing weight isn’t something everyone needs or wants to do either.

If you would like support managing your weight and you’re considering Wegovy, it’s natural to have questions about how treatment fits into everything else your body is going through. In this guide, we’ll explain how Wegovy works during menopause, what you can expect, and what you should know if you’re taking HRT too.

Why weight management is more difficult during menopause

Women gain around 1.5 kg a year on average during perimenopause as lean muscle reduces and metabolic rate slows.

Additionally, falling oestrogen levels also contribute, not only potentially causing weight gain, but also affecting where the excess weight is stored. Namely, during menopause, much of it goes toward the abdominal area in the form of visceral fat, which can negatively impact your health.

Moreover, the HSE lists loss of muscle and difficulty sleeping as common menopause symptoms, both of which can also lead to weight gain.

For more on why this happens, read our guide to menopause weight gain.

Can you take Wegovy during menopause?

Yes, you can take Wegovy during perimenopause and menopause if it's suitable for you, based on clinical assessment. The Wegovy patient leaflet says it's for adults with a body mass index (BMI) of 30 or more, or 27 or more with a weight-related health problem, alongside diet and physical activity.

Wegovy contains semaglutide, which works like a natural hormone called glucagon-like peptide-1 (GLP-1). It acts on your brain's appetite signals, helping you feel fuller and less hungry.

Losing weight may ease some menopause symptoms. One review highlights research where women who lost 10% or more of their body weight had 56% higher odds of having no hot flushes. This being said, Wegovy is not a menopause treatment, and it should not replace hormone replacement therapy (HRT), which the HSE says can help with hot flushes, night sweats, sleep problems, anxiety, and low mood.

What is the best GLP-1 for menopause?

No single GLP-1 medication is best just because you’re in perimenopause or menopause. A 2025 review found GLP-1 medicines are consistently the most effective medicines for weight loss and can be a valuable tool at this stage of life. But more research is needed into the best use of GLP-1 for perimenopause and menopause.

Our IMC-registered doctors look at your health, medical history, and preferences before recommending a treatment.

Using Wegovy and HRT at the same time

Many people use both, and they do different jobs:

  • HRT replaces oestrogen and progesterone, which fall to low levels around menopause. It eases symptoms and can help prevent osteoporosis (weak bones).
  • Wegovy helps you manage your weight by reducing your appetite.

Make sure your prescriber knows about your HRT, alongside any other medications you take. If there’s still a chance you could get pregnant and are taking contraceptives, it's important to note that Wegovy may make the pill less effective. The Faculty of Sexual & Reproductive Healthcare (FSRH) recommends adding a non-oral method, like condoms, especially for four weeks after starting and after each dose increase.

Does HRT make Wegovy work better?

Possibly, but it's too early to determine and more research is needed. A small study found postmenopausal women using hormone therapy alongside semaglutide lost 16% of their body weight after 12 months, compared with 12% for women not using it. Only 16 of the 106 women were on hormone therapy.

A 2026 study of tirzepatide, a different weight loss medicine, found a similar pattern. Both studies looked back at health records, so neither can prove hormone therapy specifically was the reason.

HRT is not a weight loss treatment, so decisions about it should be based on your menopause symptoms, health risks, and clinical needs.

Looking after your muscles and bones during menopause

While losing weight can benefit your health, during menopause, preserving what your body needs along the way matters too. Your muscle and bone health can help you stay strong, mobile, and active as you get older. Here's how you can support both while taking Wegovy.

Protecting your muscle while losing weight

When you lose weight, you lose some lean mass as well as fat. In a body composition analysis from the STEP 1 trial, people taking semaglutide lost 19.3% of their fat mass and 9.7% of their lean body mass.

This matters because falling oestrogen causes muscle mass to decline, and you also lose some muscle as you age. Staying active into older age helps you stay mobile and independent, and your muscle mass helps you keep weight off long term.

To protect your muscle:

  • include protein at every meal
  • do strength training at least two days a week, as the HSE recommends
  • aim for gradual weight loss rather than fast results

Supporting your bone health during menopause

Lower oestrogen raises your risk of osteoporosis after menopause, so menopause is already an important time to think about your bones.

A 2026 systematic review found one study linking semaglutide to more bone breakdown and lower bone density, but overall the findings were inconsistent. However, bone experts also note that weight loss itself can cause bone loss.

To look after your bones during weight loss:

  • get 800 milligrams (mg) of calcium a day from foods like yoghurt, leafy greens, and tofu
  • consider a daily 10 microgram vitamin D supplement, especially in autumn and winter
  • do weight-bearing exercise, like walking, and resistance exercise, like using weights
  • ask your GP whether a bone density scan is right for you

What about heart health?

Visceral fat, stored deep around your organs, rises from 5-8% of total body weight to 10-15% as oestrogen falls. It also links the drop in oestrogen to a significant increase in cardiovascular disease, which affects the heart and blood vessels.

When it comes to the weight that can gather around your middle, your health matters far more than how your stomach looks.

As oestrogen levels fall, your body can start storing more fat around the abdomen, including visceral fat deeper inside the body. This is why changes to your waist are worth paying attention to from a health perspective, rather than because you feel you should look a certain way. If weight around your middle is affecting your health, managing it can form part of looking after your heart and your wider wellbeing as you get older.

For more information, read our guide to why the menopause belly happens and what you can do about it.

Wegovy side effects to be aware of during menopause

Like any medication, Wegovy can cause side effects, the most common of which are digestive, such as nausea, vomiting or diarrhoea. Most people find Wegovy side effects mild and manageable as the body adjusts to the medication. Even so, there are certain side effects to be aware of, as they might overlap with menopause symptoms.

Hair thinning and hair loss

Hair can naturally become thinner during and after menopause. Changes in hormones can affect the hair follicle and contribute to more widespread thinning or shedding.

Additionally, losing a significant amount of weight, particularly quickly, can temporarily disrupt the hair growth cycle and lead to increased shedding, known as telogen effluvium.

A balanced diet with protein and iron-rich foods and gentle hair care may help. See your GP if the shedding does not improve.

For more information, read our guide to Wegovy and hair loss.

Mood and emotional wellbeing

Menopause doesn’t only affect you physically. The HSE lists low mood, anxiety and mood swings among the psychological symptoms that can happen around this time.

While there's no established link between semaglutide and low mood, a few people have anecdotally reported feeling "flatter than usual" on weight loss medication. This might be because of blood sugar fluctuations (which can cause feelings akin to anxiety), lifestyle changes, or even adapting to a changing body. Even though none of these is directly caused by the treatment, they are important to note if you're considering Wegovy during menopause, a time when you're already more prone to changes in mood.

If you start Wegovy and your mood shifts in a way that feels new, worse, or out of character, let your clinician or GP know.

Digestive symptoms

Bloating, constipation and changes to your usual bowel habits can happen around menopause. Falling levels of oestrogen and progesterone are associated with changes in digestive health, including changes to the gut microbiome.

As mentioned, digestive symptoms are also among the most common side effects of Wegovy. So, if you’re going through menopause and taking Wegovy, it can sometimes be difficult to tell what’s behind the changes you’re experiencing.

“Menopause can bring plenty of changes on its own, so if you’re starting Wegovy at the same time, it’s understandable to wonder what’s normal and what might be related to your treatment. You don’t need to figure that out alone. Let your clinical team know about any medicines you take, including HRT, and tell them about new or troublesome symptoms. We can look at the whole picture and make sure you’re getting the support that’s right for you.”

Ayesha Bashir
Ayesha BashirPrescribing Pharmacist

Side effects shouldn’t be something you have to struggle through to lose weight. How you feel throughout treatment matters too. If you're a myBMI patient, your treatment plan includes ongoing clinical support with side effects, including free medication where deemed clinically appropriate.

Learn more

How to take Wegovy safely during menopause

It's important to look after yourself if you're taking Wegovy, especially as menopause brings its own changes to the body. Luckily, there are a few things you could do to stay safe and more comfortable throughout your weight loss treatment:

  • Follow your dose schedule. Wegovy usually starts at 0.25 milligrams (mg) once a week and increases every four weeks, according to the leaflet.
  • Tell your prescriber about all your medication, including HRT.
  • Prioritise nutrition. Focus on protein and bone-friendly foods like dairy, even when your appetite is low.
  • Keep active. Strength and resistance exercise help protect muscle and bone.
  • Stay hydrated. Drink plenty, especially if you’re being sick or have diarrhoea.
  • Do not stop or change your treatment without talking to your clinician.

What about microdosing GLP-1s during menopause or perimenopause?

Microdosing means deliberately taking tiny, non-standard doses. While this topic has garnered plenty of attention online, there’s no peer-reviewed scientific evidence that microdosing GLP-1 medicines is effective or safe. It is not a proven way to reduce side effects or protect muscle.

You should always stick with your prescribed dose. Your myBMI clinical team will take your side effects into consideration when guiding you through your dose changes.

Looking after your whole health, not just the number on the scales

Weight is only one part of your health. Feeling strong, protecting your bones, eating and sleeping well, and looking after your emotional wellbeing all matter too, particularly as your body changes through menopause.

There can be enormous pressure on women to stay slim as they get older, while at the same time being expected to simply accept many of the changes that come with ageing. It’s understandable if changes to your weight or body shape affect your confidence, but they don’t mean your body has failed you or needs to be “fixed”.

If you choose to manage your weight, the goal should be about supporting your health and helping you feel well in your body, rather than trying to fit a certain ideal. Wegovy may be an option for eligible people who want or need extra support, but losing weight is a personal choice, not something you should feel pressured to do simply because your body has changed.

If managing your weight could support your health and your own goals, our clinical team can help you understand whether weight loss treatment could be suitable for you.

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Wegovy and menopause

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