Hormone Therapy May Boost Weight Loss on Wegovy, But Not as Much on Zepbound

New research shows that using hormone therapy with a GLP-1 during menopause may lead to greater weight loss. Tatsiana Volkava · Moment/Getty

A study presented at the 2026 Annual Meeting of The Menopause Society found that women using menopause hormone therapy (MHT) alongside semaglutide (Ozempic, Wegovy) experienced greater weight loss than those taking semaglutide alone.

Tirzepatide (Mounjaro, Zepbound) combined with MHT showed only modest early differences in weight loss, with no statistically significant difference at later time points.

Certain hormone therapy medications are FDA-approved to treat menopause symptoms such as hot flashes and vaginal dryness, but not for weight loss.

Experts recommend individualizing treatment decisions based on symptoms, medical history, and health goals rather than adding MHT solely to enhance weight loss with GLP-1 medications.

Females using menopause hormone therapy (MHT) alongside GLP-1 medications such as Ozempic or Wegovy may experience greater weight loss, according to a study presented at the 2026 Annual Meeting of the Menopause Society.

Weight gain is a common concern among middle-aged women. While much of this is associated with aging, hormonal changes during menopause can also contribute to changes in body fat and its distribution.

GLP-1 medications have been shown to be effective for weight loss. However, the results may vary by sex and reproductive stage.

For example, studies have found that women and adults under age 55 may experience greater weight loss with these medications.

A previous small observational study in postmenopausal women found that using MHT alongside semaglutide, the active ingredient in Ozempic and Wegovy, was associated with greater weight loss.

However, whether hormone therapy influences weight loss outcomes with different GLP-1 medications remains unclear.

To investigate this question, researchers compared weight loss in middle-aged women receiving either semaglutide or tirzepatide, with or without MHT. The findings have not yet been published in a peer-reviewed journal.

Hormone therapy linked to greater weight loss with semaglutide

The study included 3,855 women with an average age of 57 and an average body mass index (BMI) of 36 kg/m2.

The semaglutide cohort included 2,379 individuals, while the tirzepatide cohort included 1,476 individuals.

The average follow-up in the semaglutide cohort, both with and without MHT, was 26 months. The average follow-up in the tirzepatide group was 17 months for those using MHT and 16 months for those not using it.

The researchers found that in the semaglutide cohort, those using MHT alongside the GLP-1 medication had significantly greater weight loss at 9 months than those not using MHT.

These differences were sustained at 12 and 15 months and at the final follow-up. Those using MHT were also more likely to reach up to a 30% total body weight loss than those not using it. 

In the tirzepatide cohort, those using MHT had a modestly greater weight loss at 3 months and were more likely to achieve more than 5% total body weight loss by the final follow-up. However, no significant difference in weight loss was observed at later time points.

These findings suggest that MHT use may be associated with greater weight loss among middle-aged women taking semaglutide. However, the researchers did not observe a sustained, statistically significant difference in weight loss among those taking tirzepatide.

Betul Hatipoglu, MD, Director of the Diabetes and Obesity Center at the University Hospitals Cleveland Medical Center, who was not involved in the study, told Healthline that the findings are encouraging.

However, she also cautioned that people should be careful not to interpret them as evidence that hormone therapy should be added to GLP-1 treatment specifically to enhance weight loss.

“This is an association, and the study provides an opportunity to discuss how menopause, aging, changes in body composition, and metabolic health can be present,” she said.

Should women use hormone therapy with GLP-1 medications?

It is important to keep in mind that the Food and Drug Administration (FDA) has approved certain hormone therapy medications to treat menopause symptoms such as hot flashes, night sweats, and vaginal dryness. However, these medications are not FDA-approved for weight loss or obesity management. 

The study authors noted that larger studies are needed to confirm their observations and to inform individualized strategies for middle-aged females.

Sherry Ross, MD, board certified OB-GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study, noted that weight gain is one of the most common concerns she hears from women during menopause. Beyond affecting self-esteem and quality of life, excess abdominal fat can increase the risk of type 2 diabetes and hea