Study at Menopause Society Links Hormone Therapy to Semaglutide Loss
Postmenopausal women taking the GLP-1 medication semaglutide alongside hormone therapy lost roughly 2 to 4 additional pounds on average compared to peers taking the medication alone, according to research presented on October 20, 2026, at the Annual Meeting of The Menopause Society.
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Key Clinical Takeaways:
- Postmenopausal women combining semaglutide with hormone therapy achieved greater average weight loss (about 25 pounds over two years) than those using semaglutide alone (about 23 pounds).
- Women taking tirzepatide showed no statistically significant difference in final weight loss outcomes whether they utilized hormone therapy or not, despite a faster initial drop.
- Clinical investigators emphasize that hormone therapy should not be initiated solely for weight management.
Study Findings on Semaglutide and Hormone Therapy
Lead study author Regina Castaneda, a postdoctoral research fellow at Mayo Clinic in Jacksonville, Florida, reported the findings from a retrospective observational cohort study examining health records. Researchers compiled health records from about 2,400 women taking semaglutide—marketed as Ozempic and Wegovy—and approximately 1,500 women taking tirzepatide, marketed as Mounjaro and Zepbound. The study participants averaged 57 years of age with a body mass index of 36 and a starting weight of about 210 pounds.
After approximately two years, participants using semaglutide combined with hormone therapy shed an average of 25 pounds. Those taking semaglutide without hormone therapy lost an average of 23 pounds. Castaneda noted that while earlier smaller studies showed a similar association, the new data reinforces the pattern. Preclinical data indicates a potential biological mechanism where estrogen enhances GLP-1 signaling and suppresses the food reward system, though the observational design cannot establish direct causation.
Comparison With Tirzepatide Outcomes
The retrospective review tracked distinct trajectories for the dual GLP-1 and GIP receptor agonist tirzepatide. Women taking tirzepatide alongside hormone therapy demonstrated accelerated weight loss during the initial phase of treatment compared to those taking tirzepatide alone. However, by the conclusion of the study period, that divergence disappeared, yielding no meaningful difference in final weight reduction between the two tirzepatide groups.
Overall, participants taking tirzepatide achieved greater total weight loss—averaging roughly 35 pounds after 15 months—than peers taking semaglutide. This disparity aligns with previous clinical trials establishing that tirzepatide generally produces more substantial weight reduction than semaglutide.
Estrogen Reduction Causes Waist-Centric Fat Accumulation
Menopausal transition brings physiological shifts that complicate weight management even without alterations to diet or exercise routines. Makeba Williams, an ob-gyn specializing in perimenopause and menopause at the University of Illinois Hospital and Clinics in Chicago who was not involved with the study, noted that over 70 percent of her patients express concern over weight and body composition alterations. Estrogen reduction contributes to waist-centric fat accumulation, rising cholesterol levels, and elevated insulin resistance.
Despite the observed weight loss enhancement with semaglutide, clinical experts caution against prescribing hormone therapy strictly for weight management. Stephanie Faubion, medical director for The Menopause Society, explained that while the findings highlight how hormone therapy may influence GLP-1 response, treatment must account for individual symptom profiles and medical histories. Hormone therapy carries distinct benefits including vasomotor symptom relief, bone health preservation, and sleep improvement, balanced against individual risk assessments.
Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.