• It is important to use effective contraception whilst taking a GLP-1 agonist, as these medications should not be used in pregnancy.
• Patients using tirzepatide and oral contraception should switch to a non-oral contraceptive method e.g. implant, coils etc, or add a barrier method of contraception, for four weeks after initiation and for four weeks after each dose increase.
• Current evidence shows there is no need to add a barrier method of contraception when using semaglutide (Ozempic), dulaglutide, exenatide, lixisenatide or liraglutide.
• There is no data regarding interactions of GLP-1 agonist with emergency contraception (EC)-copper coil is recommended as first line as it is not affected by vomiting and diarrhoea but other options are available. However, we are uncertain whether they can be affected by GLP-1 agonist.

 
Important messages for patients using oral hormone replacement therapy (HRT)  and taking GLP-1 agonist/weight loss medications

• Delay gastric emptying can affect absorption of oral progestogen, therefore this can result in inadequate protection of the endometrium (womb lining)
• Non oral HRT (e.g. combined patch, mirena coil etc) should therefore be used in patients using Mounjaro or Ozempic
• If oral HRT is still the preferred method, then increased dose of progestogen is needed for four weeks after starting and after each dose increase of the GLP-1 agonist.
• Please seek medical help if you are on GLP-1 agonists and using oral HRT
• If you experience any abnormal bleeding, please seek urgent medical help.