Can You Take Ozempic and Metformin Together for PCOS?

Living with the symptoms of polycystic ovary syndrome (PCOS) isn’t easy. The daily struggles can feel overwhelming, and it’s totally normal to have moments where you feel defeated. You’re willing to research—maybe even try—just about anything to feel like yourself again. So, I’m sure you’ve all thought about Ozempic or metformin for PCOS—or maybe you’ve even thought about both. 

Truthfully, you don’t need either prescription to heal your PCOS symptoms. Neither provides permanent results, and both come with unpleasant symptoms. This is why I recommend intentional lifestyle changes like adopting a PCOS-friendly diet and doing slow-weighted workouts, instead! These strategies can offer real healing and long-term relief from your symptoms.

However, if you’re wondering about these two popular medications, let’s talk about them. Since both lower insulin resistance, is it safe to take them together? Here’s what you need to know:

Can You Take Ozempic and Metformin Together for PCOS?

In this post, I’ll break down what metformin and Ozempic are, how they seem to help with PCOS, and whether it’s safe to take them together. All this information is super important to understand if you’re considering the medication route for symptom management. 

What’s the Difference Between Metformin and Ozempic for PCOS?

Metformin and Ozempic can both help manage PCOS symptoms, but they work in different ways.

Metformin mainly helps reduce the amount of sugar your liver produces, which can lead to more stable blood sugar and insulin levels over time. It also helps your body become more sensitive to insulin, especially in the muscles. This can improve PCOS symptoms like irregular periods, weight gain, acne, hirsutism, hair thinning, and infertility.

Ozempic, on the other hand, works by mimicking a natural hormone called GLP-1. It helps your body release insulin, slows down digestion, and curbs your appetite. These changes are intended to support weight management and reduce type 2 diabetes symptoms.

So while metformin focuses mostly on improving insulin sensitivity to improve PCOS-specific symptoms, Ozempic only offers metabolic support focused on weight loss, diabetes-specific side effects, and long-term complications.

What Is Ozempic & How Does Ozempic Work for PCOS?

Ozempic is part of a class of medications called glucagon-like peptide-1 receptor agonists. These medications mimic GLP-1, a natural hormone in the body that helps regulate metabolism. The main ingredient of this GLP-1 receptor agonist is semaglutide, which was developed and approved by the Food and Drug Administration to help manage type 2 diabetes. 

However, quickly after it came out, people saw its potential benefits for other things, too. In this case, we’re looking at improved systems and weight loss in people with PCOS. Because insulin resistance is one of the main drivers behind many PCOS symptoms like weight gain and fatigue, Ozempic can feel like a promising option. It helps support your metabolism and can make your body more sensitive to insulin. As long as you’re taking your weekly injections, that is. 

Here’s more on why I don’t recommend Ozempic for PCOS.

What Is Metformin & How Does Metformin Work for PCOS?

Metformin, like Ozempic, is a medication originally designed for people with type 2 diabetes to stabilize blood glucose levels. However, it’s one of the main prescriptions used for PCOS symptom management. Specifically, it helps with irregular periods, acne, weight gain, and infertility. It does all this by increasing insulin sensitivity. 

However, metformin doesn’t reduce insulin resistance in the same way Ozempic does. Unlike Ozempic, which mimics the GLP-1 hormone, metformin works by activating an enzyme called AMPK—an important metabolic regulator. This is like your metabolism’s on-and-off switch. So, when switched on, AMPK reduces glucose production in the liver and helps your cells become more responsive to insulin.

Just like Ozempic, metformin only works when you’re taking it. It doesn’t change anything permanently in your body to improve insulin sensitivity. That means once you get off metformin, you’ll likely see symptoms return if you haven’t made the necessary lifestyle changes. Here’s more on my thoughts on metformin for PCOS. 

What Happens if You Take Metformin and Ozempic Together for PCOS?

You can take Ozempic and metformin together for PCOS, but you’ll need a healthcare provider with a good understanding of both drugs. A doctor will help determine the right dosage for each medication to make sure they work well together. While they can reduce insulin resistance, they can also lower your blood sugar or insulin levels too much. This is especially true if you’re not on the correct dosage or schedule.

The Good: Improve Insulin Resistance 

Since Ozempic and metformin have different methods of improving insulin sensitivity, they can accelerate symptom relief and weight loss in people with PCOS. The GLP-1 and AMPK action combined helps reverse stubborn weight gain, reduce cravings, boost energy, and regulate menstrual cycles. 

The Good: Balances Hormones

High insulin and blood sugar levels can signal the ovaries to produce more testosterone. High testosterone levels then disrupt ovulation, which throws off the rest of the cycle. When you don’t go through the other phase of your cycle correctly, estrogen and progesterone get off balance as well. 

Therefore, significant improvements in insulin sensitivity can indirectly balance hormones as well. This can relieve symptoms like acne, hirsutism, hair loss, irregular periods, infertility, and mood swings.

The Good: Better Cholesterol Levels 

When you reduce insulin resistance, you also lower your body’s need for cholesterol—and that’s exactly how Ozempic and metformin can work together to support heart health. Metformin helps your liver process sugar and fat more efficiently, which can bring down LDL cholesterol and triglycerides. 

Ozempic supports weight loss, curbs cravings, and improves your body’s insulin response, all of which take pressure off your metabolism. When used together, they help lower excess insulin, which is a major driver of high cholesterol. So, taking metformin and Ozempic can help balance lipid levels and reduce the risk of heart complications associated with PCOS.

The Bad: GI Symptoms

One of the big problems with prescription solutions to symptom management is the long list of potential side effects. Basically, it can feel like trading one set of symptoms for another. Especially when you learn that gastrointestinal side effects like bloating, gas, nausea, and diarrhea are all common side effects of Ozempic and metformin. So, when taken together, it can amplify side effects and cause some pretty significant GI discomfort. 

The Bad: Low Blood Sugar 

Since both Ozempic and metformin lower blood sugar, if the dosing isn’t right (or you’re taking insulin-sensitizing supplements as well), the combination of medications can cause hypoglycemia. This is when your blood sugar drops too low, potentially causing fatigue, dizziness, shakiness, or even fainting. 

For more on this, check out: “What’s the Relationship Between PCOS and Hypoglycemia?” 

The Bad: Vitamin B12 Deficiency 

People taking metformin are often warned about the risk of vitamin B12 deficiency because the medication can interfere with how your body absorbs B12 in the gut. Women with PCOS are usually encouraged to eat more B12-rich foods to help prevent this. However, since Ozempic can reduce your appetite, it might make it harder to get enough B12 from food alone. This, naturally, could worsen an already-present deficiency. If you’re low in B12, you may experience symptoms like fatigue, brain fog, irritability, mood swings, muscle weakness, and more.

The Bad: High Medication Costs

Both metformin and Ozempic are only FDA-approved to treat type 2 diabetes. Insurance often doesn’t like to cover meds that are being used off-label. So, using metformin or Ozempic for PCOS can be really expensive. Metformin is generally $10-$30 a month, but Ozempic injections are closer to $800-$1,500 a month without insurance. 

How Do You Take Metformin and Ozempic Together for PCOS Effectively?

If you’re going to take medications like Ozempic and metformin, it’s important to do so with your long-term goals in mind. Here’s how to take metformin and Ozempic together:

Double-check that the medications are right for you. 

Ozempic and metformin can be dangerous for people with certain medical issues or pre-existing conditions. So, make sure your doctor is fully informed about your current health and family history. 

Don’t take metformin and Ozempic together if you: 

• Have a personal or family history of Multiple Endocrine Neoplasia Syndrome Type 2 (MEN2) or Medullary Thyroid Carcinoma (MTC)
• Have Type 1 Diabetes 
• Have Severe Kidney or Liver Disease
• Are Pregnant or Breastfeeding
• Struggle with GI Issues

Find the right starting doses with your doctor. 

A doctor will start you low and slow on your medications to see how your body reacts. Generally, that means 500 mg of metformin once or twice a day, and 0.25 mg of Ozempic once a week. 

Take metformin with food.

To reduce the risk of GI symptoms, it’s important to take metformin with a meal. This is especially true with immediate-release metformin, when food can slow down the absorption rate.

Inject Ozempic once a week at the same time. 

You don’t need to take Ozempic with a meal, but you should still stay on a schedule. Do your injections once a week at the same time for the best results. 

Monitor your blood sugar regularly. 

Regularly monitor your blood sugar to avoid unwanted dips or spikes. You may even want to consider a continuous glucose monitor. 

Focus on lifestyle changes for permanent results. 

At the end of the day, every medication should have an exit plan. I don’t recommend Ozempic or metformin for PCOS, because natural lifestyle changes can be more effective, offer permanent results, give you comprehensive symptom relief, and are totally side-effect free. However, even if you choose to take these medications, make positive lifestyle changes while on it. These lifestyle changes, ultimately, can reduce your body’s need for blood sugar support.

You can jump into my full guide to managing PCOS naturally, but here are the highlights:

• Try a gluten- and dairy-free anti-inflammatory diet
• Cut back on alcohol and caffeine
• Drink Testosterone Relief Tea
• Stay hydrated 
• Take high-quality, PCOS-friendly supplements from Ovafit
• Use probiotics
• Do regular, slow-weighted workouts
• Get better sleep
• Reduce stress levels 
• Avoid endocrine disruptors
• Consider acupuncture 

You can find lasting relief and heal your PCOS naturally—without Ozempic or metformin!

Sometimes medications can seem like the only way forward when you’re dealing with conditions like PCOS. However, there are lots of natural ways to get to the root of your symptoms and support long-term healing. By reversing insulin resistance, balancing hormones, and reducing inflammation, you can find real relief without the side effects, risks, or high costs associated with medications like metformin and Ozempic.

Not sure where to start? Download The Cysterhood app. You’ll get access to PCOS-friendly recipes, targeted workouts, helpful resources, symptom-tracking tools, and a whole community of supportive Cysters who get exactly what you’re going through. We can’t wait to have you!

And, if weight loss specifically is your goal, check out these posts: