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ForumsSide Effects & ManagementGLP-1 and menstrual irregularity — hormone changes during weight loss

GLP-1 and menstrual irregularity — hormone changes during weight loss

Dr.ReproEndo Sat, May 9, 2026 at 7:32 PM 15 replies 681 viewsPage 1 of 3
Dr.ReproEndo
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May 9, 2026 at 7:32 PM#1

Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.

Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect. Less adipose tissue means less aromatase activity, so in men testosterone commonly rises and estradiol falls, and SHBG rises as insulin resistance improves — which means total testosterone can rise while free testosterone moves less than expected. In PCOS, improved insulin sensitivity frequently restores ovulation, which is a fertility change people are not always expecting.

Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.

What would genuinely help is knowing why total and free can move differently here, and which of the two is worth tracking. Not looking for reassurance. Looking for the part I have got wrong.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
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Dr.SurgeonPGH
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May 9, 2026 at 9:14 PM#2
Dr.ReproEndo said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

Sex hormone labs after weight loss on the hormone panel — for the men in this thread:

Testosterone: 312 → 552 ng/dL (dramatic improvement!)
Free T: 6.7 → 12.2 ng/dL
Estradiol: 44 → 22 pg/mL
SHBG: 18 → 46 nmol/L

Visceral fat contains aromatase which converts testosterone to estrogen. As you lose visceral fat, this conversion decreases and testosterone naturally rises. I feel 10 years younger.

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BenResearch_OR
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May 9, 2026 at 10:56 PM#3
Dr.ReproEndo said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection:

4-point salivary cortisol:

  • Morning: 19 ng/mL → 14 ng/mL (improved)
  • Noon: 9 ng/mL → 5 ng/mL
  • Evening: 4 ng/mL → 2 ng/mL
  • Night: 2 ng/mL → 1 ng/mL

The cortisol curve is normalizing — less flat, better diurnal variation. Reduced visceral fat = reduced cortisol overproduction. The metabolic benefits cascade into stress hormone regulation.

Last edited: May 9, 2026 at 11:56 PM
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Dr.EndoIndy
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May 10, 2026 at 12:38 AM#4
BenResearch_OR said:
HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection: 4-point salivary…

Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects:

  • Testosterone: increased 28% (weight loss reduces aromatase in adipose tissue)
  • Estradiol: normalized from elevated baseline
  • SHBG: increased appropriately
  • Free testosterone: increased 31%
  • Cortisol AM: within normal limits, no significant change

My reproductive endocrinologist says the testosterone improvement alone could explain the energy and mood benefits I've experienced.

Last edited: May 10, 2026 at 3:38 AM
6 1DeniseRN_TPA, SandraNC_45, Dr.EndoIndy and 3 others
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pete_RVA
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Richmond, VA
May 10, 2026 at 10:40 AM#5
Dr.SurgeonPGH said:
Sex hormone labs after weight loss on the hormone panel — for the men in this thread: Testosterone: 312 → 552 ng/dL (dramatic improvement!) Free T:…

This is my experience too, for whatever a second data point is worth. Posting only so the count is not one.

5 0Dr.LeslieOBGYN, MikeNYC_runner and 2 others
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