Micro-Dosing GLP-1s: A Safe Solution for Menopause Symptoms?
The conversation around GLP-1 medications—Ozempic, Wegovy, Mounjaro and now, pills—has exploded in recent months, largely fueled by celebrity endorsements and a societal focus on weight loss. But a growing number of women are turning to these drugs, or more specifically, micro-doses of them, to manage the often-debilitating symptoms of perimenopause and menopause. Jana Stewart, a 54-year-ancient hormone and midlife health coach and bodybuilder, is one of them, and her experience, detailed in a recent Essence article, is sparking a wider discussion about a new approach to navigating this life stage.
Stewart’s story is relatable for many: despite maintaining a healthy lifestyle with regular exercise and a balanced diet, she found herself gaining weight during perimenopause—about 15 pounds that wouldn’t budge. Traditional methods stopped working, leading her hormone specialist to suggest Wegovy. After initial weight loss on a full dose, she transitioned to micro-dosing, taking just 10 units weekly to maintain a weight of 125 pounds. For Stewart, the benefit isn’t solely about the numbers on the scale. “The difference is that micro-dosing isn’t about weight loss for me anymore—it helps tremendously with cravings and inflammation, which are huge for managing perimenopause symptoms,” she told Essence.
The Menopausal Weight Gain Struggle is Real
Stewart isn’t alone in her experience. Dr. Roxanne Pero, an OBGYN and member of O Positiv’s Medical Advisory Board, notes that 60 to 70 percent of women in midlife report weight gain during the menopausal transition, potentially reaching 22 to 25 pounds. This isn’t simply a matter of aesthetics. it’s a physiological shift. And, as the Essence article points out, Black women often start menopause with a higher body weight and more abdominal fat compared to White women, potentially experiencing a different pattern of weight gain throughout the process. Research published in the National Institutes of Health supports this disparity, highlighting the complex interplay of hormonal changes, genetics, and socioeconomic factors.
The appeal of GLP-1s, then, is understandable. These medications, originally developed for type 2 diabetes, work by mimicking a naturally occurring hormone that regulates blood sugar, increases feelings of fullness, and controls appetite. Drugs like Ozempic and Wegovy have gained notoriety thanks to endorsements from celebrities like Serena Williams, Whoopi Goldberg, Oprah, and Vanessa Williams, with approximately one in eight Americans having tried them, according to a KFF poll.
Micro-Dosing vs. Full Doses: A Different Approach
Whereas the initial surge in GLP-1 use focused on significant weight loss, the trend towards micro-dosing—using a much lower dose than prescribed for weight management—is gaining traction, particularly among women in perimenopause. Stewart’s experience exemplifies this shift. The lower dose, she finds, effectively manages cravings and inflammation without the more dramatic effects of a full dose. This approach aligns with a growing understanding of hormonal balance and the need for individualized treatment during midlife.
However, the use of GLP-1s isn’t without risk. Since 2023, class action lawsuits have been filed against manufacturers like Novo Nordisk (Ozempic and Wegovy) and Eli Lilly (Mounjaro), alleging severe side effects such as gastroparesis (delayed stomach emptying) and vision loss. Lawsuit Tracker currently lists over 3,000 pending cases related to gastroparesis and 29 concerning vision loss. The National Institute of Diabetes and Digestive and Kidney Diseases defines gastroparesis as a condition that slows or stops the movement of food from the stomach to the small intestine, causing symptoms like nausea, vomiting, and weight loss.
Balancing Benefits and Risks
It’s important to note that many of the reported side effects appear to be more common with higher doses or prolonged use. While gastrointestinal issues can occur with micro-dosing, they are generally milder as the body adjusts. Dr. Sarah De La Torre, a double board-certified physician at Respin, notes that she has many patients experiencing benefits like decreased inflammation, weight loss, and improved mental clarity on low doses of Tirzepatide.
Pero cautions that hormonal shifts during menopause can exacerbate potential side effects. “During menopause, these changes can be compounded by hormonal shifts—declining estrogen and testosterone levels naturally reduce muscle mass and can contribute to hair thinning,” she warns. She emphasizes the importance of adequate protein intake, nutrient-dense meals, and regular weight training to preserve muscle and minimize hair loss.
The Rise of GLP-1 Pills and What’s Next
The accessibility of GLP-1s is similarly evolving. The recent arrival of GLP-1 pills on the market promises easier dosing than injections. However, the long-term risks of these medications remain a subject of ongoing research. While GLP-1s have been used to treat type 2 diabetes since 2005, their widespread use for weight loss is relatively recent, raising questions about the long-term effects.
Stewart emphasizes the importance of open conversation and access to resources. “So many of us are struggling in silence, not knowing what options are available or feeling like we just have to ‘tough it out’,” she says. Whether it’s GLP-1s, support groups, or lifestyle changes, she believes women should feel empowered to explore all available options.
As the conversation around GLP-1s continues, it’s clear that a nuanced approach is needed—one that acknowledges both the potential benefits and the potential risks, and prioritizes individualized care and informed decision-making. The emergence of GLP-1 pills and ongoing research will undoubtedly shape the future of this evolving landscape, but for now, the focus remains on empowering women to navigate the challenges of menopause with knowledge and support.