You can eat
- Dairy products or calcium-fortified plant-based drinks to support bone health during menopause.
- Oily fish, eggs or foods fortified with vitamin D.
- Lean meat, pulses, shellfish or eggs if menstrual bleeding leaves you with low iron levels.
- Fruit, vegetables and enough water throughout the day, especially if you feel nauseous.
What to avoid
- Changing your contraception or its dose on your own, without speaking to the person who prescribes it.
- Skipping meals or eating very little to lose weight faster, especially if you are planning a pregnancy.
- Dismissing bleeding after twelve months without a period during menopause.
- Taking iron, calcium or vitamin D supplements without a healthcare professional recommending them.
Changes that help
Contraception
Instead of stopping the pill because you are worried it may fail, ask whether you should use additional contraception, as condoms are advised when starting Mounjaro and after increasing the dose.
Trying for a pregnancy
Instead of stopping your GLP-1 medicine without telling anyone, speak to the person who prescribes it to agree when to stop, as each medicine has its own recommended washout period.
Days when you have vomiting or diarrhoea
Instead of assuming the pill is still working as usual, follow its patient information leaflet for these circumstances, as absorption may be reduced.
Menopause
Instead of waiting for your annual review, ask at your next appointment whether hormone treatment is appropriate for your circumstances; the decision should be made with you.
Habits that help
- Keep a record of your menstrual cycle or any unexpected bleeding to discuss at your appointment.
- Take the contraceptive pill at the same time each day; set a phone reminder if that helps.
- Do strength training two or three times a week, particularly after menopause.
- If you are menopausal, ask whether it is time for a bone-density assessment.
This question comes up in different ways in consultations. One woman takes the pill and wonders whether the medicine could make it less reliable. Another is hoping to become pregnant and is unsure when to stop treatment.
Someone else is approaching menopause and wonders whether it changes how the medicine affects her. The underlying answer is the same for all three: make the decision with the person who prescribes your GLP-1 medicine, and arrive at your appointment knowing what you want to ask.
Can a GLP-1 medicine make my contraception fail?
GLP-1 medicines slow gastric emptying, so they could affect how a tablet taken at the same time is absorbed. This has been studied with the contraceptive pill for oral semaglutide (Rybelsus) and tirzepatide (Mounjaro).
With semaglutide, the combined pill showed no relevant change in its levels [1]. With tirzepatide, a single dose lowered the peak level and the total amount of hormone reaching the blood [2]. The European product information does not consider this clinically relevant and does not require a change to the pill [2].
The UK medicines regulator takes a more cautious approach [3]. If you take the pill and use Mounjaro, it advises adding a barrier method, such as condoms, for four weeks after starting and for a further four weeks after each dose increase. This is a question to take to the person who prescribes your medicine.
The IUD, implant, vaginal ring and patch do not depend on absorption through the digestive system. If you use tirzepatide, discuss with your healthcare professional which contraceptive method is right for you.
Should I change or use additional contraception?
No product information says that you must stop taking the pill. They all say to use effective contraception while taking the medicine if pregnancy is possible [1] [2]. With Mounjaro, this is supplemented by the advice to use additional contraception during the first few weeks and after each dose increase [3].
If you have polycystic ovary syndrome, do not assume that having no periods means you cannot become pregnant. Some studies have associated GLP-1 medicines with more spontaneous pregnancies [4]; use effective contraception during treatment.
Prolonged vomiting or diarrhoea reduces the effectiveness of any pill. On those days, follow the instructions in your pill’s patient information leaflet and discuss it with the person who prescribes your GLP-1 medicine.
Why are GLP-1 medicines not used during pregnancy?
The product information for semaglutide and tirzepatide states that data in pregnant women are limited. Animal studies showed reproductive toxicity [1] [2]. For this reason, the semaglutide product information says it should not be used during pregnancy, while the tirzepatide product information says it is not recommended [1] [2].
This does not mean that a pregnancy exposed to the medicine will have a poor outcome. It means there is not enough information to rule out a risk. Given this uncertainty, it is preferable not to use it while trying to conceive or during pregnancy.
Stopping a GLP-1 medicine when planning a pregnancy
The GLP-1 medicine is stopped in advance of trying to conceive. The semaglutide product information says to stop it at least two months before a planned pregnancy because of its long half-life [1]. The tirzepatide product information says to stop it at least one month beforehand, also because of its half-life [2].
The person who prescribes your medicine will set that timetable. If you would also like to work on your diet while planning a pregnancy, see our guide to eating before pregnancy to support fertility.
What if I become pregnant unexpectedly?
If you think you may be pregnant while using semaglutide or tirzepatide, contact the person who prescribes it immediately to stop treatment [1] [2] and arrange follow-up with your midwife or gynaecologist.
Can I take a GLP-1 medicine while breastfeeding?
With oral semaglutide, the Rybelsus product information reports that the medicine was not detected in breast milk. Other components of the tablet were present at low concentrations. As a risk to the baby cannot be ruled out, it should not be used while breastfeeding [1].
While breastfeeding, the Spanish AEMPS product information for tirzepatide allows it to be considered in some cases [2], but data on the infant and breast milk are lacking. Do not start or continue a GLP-1 medicine without discussing it with your doctor [3].
These are two different medicines, and the guidance is not the same. Your doctor should decide whether to continue, pause or wait; the guidance for one GLP-1 medicine cannot be applied to another.
Does treatment change during menopause?
Menopause can change body composition. If you use a GLP-1 medicine, discuss with your care team how your strength, diet and treatment effects are changing.
Hormone therapy for menopause symptoms is a separate decision. It is made with you, taking account of your symptoms and the benefits and risks in your individual circumstances [5]. Your GP or gynaecologist can assess this, rather than the team supporting you with your GLP-1 medicine.
If you are also concerned about maintaining muscle as your weight decreases, this is covered in our guide to protein and muscle with a GLP-1 medicine. If you would like to learn more about eating during this stage, see our guide to eating during menopause.
What questions come up in consultations?
- “Can taking Ozempic make me pregnant?” The medicine does not prevent pregnancy, and fertility may increase as you lose weight. If you are not planning a pregnancy, continue to use an effective contraceptive method.
- “Do I have to stop the pill while I take the medicine?” No. Continuing to use an effective contraceptive method is recommended; with Mounjaro, ask about using additional contraception.
- “I have not had a period for a year and now I have spotted. Is it menopause or the medicine?” This is a question for your doctor, not something to manage by adjusting treatment yourself.
And the question that almost always comes at the end. This guide does not replace your gynaecologist or the person who prescribes your GLP-1 medicine. It provides context to help you have a conversation with them and ask better questions.
The pill, pregnancy and menopause are not things to manage alone: there is always a healthcare professional to help you make these decisions.
We do not prescribe GLP-1 medicines or adjust their dose, and we cannot change your contraception for you. Those decisions are for your doctor, gynaecologist or midwife. Our role in GLP-1 nutrition support is to help with food, protein and habits that support you during treatment while you make those decisions with your healthcare professional.
For an overview of GLP-1 medicines, see our guide to GLP-1 medicines.
Your first step this week
Speak to the person who prescribes your GLP-1 medicine
Before your next dose, ask whether your contraception, plans for pregnancy or stage of menopause affect your treatment plan.
Your first 16 weeks on a GLP-1
- What to eat at each dose increase
- 7-day menu with five small meals
- How to protect your muscle and what to do about side effects
Where should we send it?
Free PDF, in your inbox in a moment.
Data controller: Alimmenta Tu Vida, S.L. Purpose: to send you the guide and, only if you tick the second box, tips by email on the topic. You can withdraw your consent and exercise your rights at [email protected]. Legal basis, recipients and retention periods are in our privacy policy.
When to see a doctor
When to seek medical advice
The limit. With a GLP-1 medicine, we support your diet during and after treatment. We can help you eat enough protein, preserve muscle, do strength training and maintain habits that support your weight after you stop taking it. We do not prescribe the medicine, adjust its dose or replace the person who prescribes it. If the medicine is causing you problems, discuss this with your doctor.
Warning signs.
- If you have severe, persistent abdominal pain that may spread to your back, seek immediate medical attention. (AEMPS and MHRA)
- If you are vomiting or have diarrhoea and cannot drink or keep fluids down, seek advice as soon as possible to avoid dehydration. (AEMPS)
- If you have severe pain in the upper right part of your abdomen, yellow skin or eyes, or very pale stools, seek medical attention. (AEMPS)
- If your blood sugar is dropping and you use insulin or medicines that can lower it too much, contact your medical team as soon as possible. (AEMPS)
- If you notice changes in your vision during treatment, seek medical advice as soon as possible, especially if you have diabetic retinopathy. (AEMPS and MHRA)
- You are losing weight very quickly, with marked weakness and loss of strength (GIRO and SEEDO guidelines, 2024)
What to do. If you have severe, persistent abdominal pain, with or without vomiting, go to A&E today or call 112: it could be pancreatitis (inflammation of the pancreas). If you have pain in the upper right part of your abdomen, yellow skin or eyes, or very pale stools, also go to A&E today. If you cannot drink, contact your doctor today; if you also feel dizzy when standing up or are passing very little urine, go to A&E. If a drop in blood sugar is severe (confusion, inability to swallow or needing help from another person), call 112. If you can swallow and your blood glucose is below 70 mg/dl, take 15-20 g of glucose and check it again after 15 minutes. If you have mild episodes of low blood sugar or changes in your vision, contact the person who prescribes your medicine as soon as possible. If you suddenly lose your sight, go to A&E. If you are losing weight very quickly and feel weak, contact your doctor this week: strength training and protein can help, and your treatment plan should be reviewed.
Closing note. Most troublesome effects of GLP-1 medicines are digestive, temporary and manageable. These are the few signs that call for stopping and seeking advice.
Alimmenta's GLP-1 programme
Make sure what you lose is fat, and that it lasts when you stop
We support you from the first dose until a year after you stop: protein, digestive symptoms, strength, body composition and an exit plan.
- Assessmentbefore you start
- Dose escalationweeks 0-16
- Active weight lossmonths 4-12
- Plateau and maintenancefrom month 12
- Landingup to a year after stopping
4.9 ★ Google5.0 Doctoralia2,047 reviews23,000+ patients
First visit · 45 min, in clinic or online
First visit €60
Recommended for a long treatment
10-visit pack · €480
€48 per visit. How long each phase lasts depends on you.
We don't prescribe or change your dose: your doctor does that. We work alongside them.
Keep reading
Mounjaro: uses, doses, cost and what to eat
If you have been prescribed Mounjaro, you may be concerned about nausea, the cost or what happens when…
Protein and muscle with Ozempic or Mounjaro: how to look after muscle mass
Your weight is going down, but you are worried about losing strength and ending up weaker than you…
Tiredness and hair loss with Ozempic or Mounjaro: why it happens and what may help
You have lost weight with the treatment, but you feel low on energy and are losing more hair…
GLP-1 medicines: what they are and which are available in Spain
Perhaps one of these medicines has been suggested to you and you would like to understand why there…
- Consultation
Nutrition support with GLP-1 (Ozempic, Wegovy) in Barcelona and online
The medicine takes away your appetite. What you eat even when you have less appetite, and what happens…
Book a visit →
Sources
- [1] Spanish Agency of Medicines and Medical Devices (AEMPS). Summary of product characteristics: Rybelsus (semaglutide) tablets. CIMA; accessed in 2026. https://cima.aemps.es/cima/dochtml/ft/1201430008/FT_1201430008.html.
- [2] Spanish Agency of Medicines and Medical Devices (AEMPS). Summary of product characteristics: Mounjaro (tirzepatide) solution for injection in a pre-filled pen. CIMA; accessed in 2026. https://cima.aemps.es/cima/dochtml/ft/1221685014/FT_1221685014.html.
- [3] Medicines and Healthcare products Regulatory Agency (MHRA). GLP-1 medicines for weight loss and diabetes: what you need to know. GOV.UK; 2025, updated in 2026. https://www.gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know.
- [4] Zhou L, Qu H, Yang L, et al. Effects of GLP1RAs on pregnancy rate and menstrual cyclicity in women with polycystic ovary syndrome: a meta-analysis and systematic review. BMC Endocr Disord. 2023;23:245. doi:10.1186/s12902-023-01500-5.
- [5] National Institute for Health and Care Excellence. Menopause: identification and management (NG23). 2015, updated in 2024. https://www.nice.org.uk/guidance/ng23.
Written and reviewed by
How we can help
Now, applied to you
Nutrition support with GLP-1 (Ozempic, Wegovy) in Barcelona and onlineThe medicine takes away your appetite. What you eat even when you have less appetite, and what happens when you stop it, is what we work on here.
4.9 on Google · 5.0 on Doctoralia · 2,047 reviews
