Hormone Therapy May Enhance Weight Loss with Semaglutide but Shows Limited Impact with Tirzepatide

Recent research indicates that middle-aged women using menopause hormone therapy (MHT) alongside semaglutide—a medication commonly known as Ozempic or Wegovy—may experience increased weight loss compared to those taking semaglutide alone. This finding was presented at the 2026 Annual Meeting of the Menopause Society, highlighting the potential benefits of combining these treatments during menopause.

Weight gain is a prevalent concern for many women during midlife, often exacerbated by hormonal changes associated with menopause. These changes can lead to shifts in body fat distribution and overall body composition. While GLP-1 medications like semaglutide have been recognized for their efficacy in promoting weight loss, how they interact with hormone therapy remains an area of interest for researchers.

In this study, scientists examined the weight loss outcomes of 3,855 women, averaging 57 years old, who were treated with either semaglutide or tirzepatide (branded as Mounjaro or Zepbound). The participants were divided into groups based on whether they also received MHT. Initial findings suggested that those taking semaglutide along with MHT experienced significantly greater weight loss at nine months than those not using MHT. This trend continued at subsequent follow-ups, with MHT users showing a higher likelihood of achieving a total body weight loss of 30% or more.

Conversely, the results were less pronounced among women using tirzepatide. Although there was a slight increase in weight loss for those on MHT at the three-month mark, no significant differences were noted at later follow-ups, suggesting that the combination may not have the same effectiveness as it does with semaglutide.

Experts caution against interpreting these results as a straightforward endorsement of adding hormone therapy solely for weight loss enhancement. Dr. Betul Hatipoglu, a diabetes and obesity specialist, emphasizes the importance of personalized treatment plans that consider a woman’s specific symptoms, medical history, and overall health goals. Hormone therapy is primarily approved for alleviating menopausal symptoms like hot flashes and vaginal dryness, not for weight management.

Dr. Sherry Ross, a women’s health expert, highlights that weight gain during menopause is a common concern that can affect self-esteem and overall health, increasing risks for conditions such as type 2 diabetes and heart disease. She advocates for more robust studies to explore the combined effects of GLP-1 medications and hormone therapy on weight loss and maintenance.

When considering treatment options, women are encouraged to consult with healthcare providers to weigh the risks and benefits of each approach. While hormone therapy can alleviate menopausal symptoms that might hinder exercise and weight management, GLP-1 medications are effective for obesity treatment and improving metabolic health.

Ultimately, successful weight management during and after menopause extends beyond mere numbers on a scale. Factors such as muscle mass preservation, bone health maintenance, and overall physical function play critical roles in long-term well-being.