A new study from Flinders University has highlighted low contraceptive usage among women taking GLP-1 receptor agonists.
A new study published in the Medical Journal of Australia has showcased a link between GLP-1 use and unintended pregnancies.
Flinders University researchers looked at the health data of over 1.6 million women between the ages of 18 and 49, collected between 2011 and 2022.
The prescription of GLP-1s has seen an increase in Australia for women of reproductive age, increasing from 0 to 14.9 per 1000 women from 2011 to 2022.
Of the roughly 6300 women were first prescribed GLP-1s during 2022, just under 10% had type 2 diabetes.
Around 2.2% of women that started GLP-1 treatment became pregnant within six months.
“… Modest reductions in weight can improve fertility, the risk of unintended pregnancy is significant if effective contraception is not used,” the researchers wrote in the MJA.
“Conversely, the use of GLP-1 receptor agonists for improving fertility has attracted interest, but even during intended pregnancies their use entails risks.
“Further, GLP-1 receptor agonists may reduce the effectiveness of oral contraception by altering drug absorption, but the clinical significance of this interaction was questioned in a recent systematic review.”
The RACGP called for further research into the interaction between fertility and GLP-1s.
“There is a theoretical risk, not proven, that injectable medications may reduce the effectiveness of oral contraception, and so that that might be a part of it,” RACGP obesity specific interests chair Dr Terri-Lynne South told The Medical Republic.
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“We don’t have enough data to tell us [the] … percentage of people falling pregnant because of a failure of oral contraception, as opposed to that they weren’t taking contraception.”
Recommendations from the study suggest that clearer practice recommendations need to be implemented for women with polycystic ovary syndrome, type 2 diabetes and obesity, with a focus on ensuring consistent contraceptive care.
“In Australia, we’ve got a risk pregnancy risk category, so going from A through to B, C, D, and then x,” Dr South told TMR.
“The pregnancy category risk is Category D.
“That’s why we do need to make sure that our patients are taking reliable contraception and understand what their pregnancy planning would be before prescribing the long term injectables.”
Dr South said the best action GPs can take is to open up the discussions of fertility when prescribing GLP-1s.
If a patient is being motivated to look at their metabolic health using these medications purely for pregnancy planning, it is a bit of a dilemma,” Dr South told TMR.
“I feel as though there’s still some misinformation that using these medications is short term and it’s not.
“We need to understand if someone is using the medication to increase their fertility, they’re going to have to stop the medication at some time.”
