At 16 years old, Megan Rappa was missing school for what felt like a full system breakdown.
She’d suffered irregular and painful periods for years before a gynecologist finally named her condition — but still, nothing changed.
“Even with a diagnosis, my symptoms were just mine to deal with and there was not a solution outside of just trying to lose weight [and] hormonal birth control,” Rappa, now 29, told The Post.
For decades, millions of women have been told to lose weight, exercise more or simply “wait and see.” Many left doctors’ appointments feeling unheard, frustrated and still searching for answers.
Now, a growing number are turning to off-label GLP-1 drugs like Ozempic in the hope of managing a condition that has long been misunderstood: polycystic ovary syndrome (PCOS).
PCOS — which has recently been renamed polyendocrine metabolic ovarian syndrome (PMOS) — affects an estimated 1 in 10 women of reproductive age, making it one of the most common hormonal disorders in the world.
It causes symptoms like unpredictable periods, rapid weight gain, painful cystic acne, coarse facial and body hair, scalp hair thinning, skin issues, difficulty becoming pregnant, debilitating fatigue, anxiety and depression.
The condition is often reduced to a fertility condition or a weight problem, but specialists increasingly describe it as a complex metabolic disorder that can affect nearly every part of a woman’s body, hence the recent name change.
It’s no wonder, then, that treatment options — which include losing weight and going on medications to address specific symptoms — have been imperfect, leaving many women searching for better options.
As GLP-1 drugs like Ozempic, Mounjaro and Zepbound have exploded in popularity — helping people with diabetes, weight loss and a growing list of other conditions — more and more women are hoping they hold the answers to their PMOS troubles, too.
In 2021, 2.4% of women with PMOS were prescribed semaglutide or tirzepatide, according to Truveta. By 2025, the share had jumped to 17.6% — more than a sevenfold increase.
“I’d say around 30% of my patients with PMOS arrive already having been on GLP-1 before we’ve discussed anything clinically,” said Dr. Zaher Merhi, a reproductive endocrinologist at Albert Einstein College of Medicine who researches both PCOS and GLP-1 drugs.
Online interest has gone up too: Searches for “Ozempic fertility” rose about 600%, he said, while “Ozempic getting pregnant” rose 900% and “Ozempic babies” rose 1,100% over the prior year.
“Social media is running years ahead of the healthcare system here, for better and worse,” said Dr. Michael Botta, a healthcare economist and former White House Office of Management and Budget official who has tracked the trend closely.
“These are women who have often spent a decade being told to ‘lose weight and come back,’ and they’re now watching peers with the same condition describe regular cycles, improved labs and pregnancies after starting a GLP-1.”
The patient is often the one introducing the drug into the conversation — not the doctor, he said.
It’s more than stubborn weight gain, and many women suffer in silence
Stories of women dismissed by doctors have become a recurring theme across PMOS communities. Research suggests many women wait years for a diagnosis and consult multiple healthcare professionals before someone connects the dots.
Such was the case for Rappa, who was diagnosed as a teen. And years later, when she mentioned trying a GLP-1 to her primary care physician, the doctor “was quick to write me a prescription for metformin” instead. It didn’t help.
Hillary Stanfield, 39, was diagnosed at 26 years old. But looking back, she had symptoms long before that.
“From the time I began my menstrual cycle at 12 years old, I was experiencing very heavy cycles that would last weeks at a time,” she said. “I sometimes had to stay home from school and had very low iron readings.”
Even when she got her diagnosis, she wasn’t satisfied with what she learned.
“I still remember feeling frustrated that there weren’t many treatment options beyond ‘lose weight’ or take metformin,” Stanfield said. “It often felt like I was managing symptoms instead of addressing the underlying condition.”
Certainly, part of the problem is that symptoms are frequently treated in isolation. A dermatologist addresses acne, a gynecologist focuses on irregular periods and a fertility specialist investigates infertility. Meanwhile, the underlying hormonal and metabolic disorder may go unrecognized.
“PCOS affects roughly 1 in 10 women, yet for decades it was treated as a cosmetic or weight problem rather than the metabolic and endocrine condition it is,” Merhi said.
“Part of that comes from a broader pattern in women’s health research being underfunded relative to disease burden.”
Are GLP-1s the cure?
For many women, insulin resistance sits at the center of the condition. Because their bodies don’t respond to insulin efficiently, the pancreas releases even more — triggering the ovaries to produce excess androgens, disrupting ovulation and setting off a cascade of symptoms. Part of how GLP-1s work is by improving the body’s ability to control insulin.
Some studies have shown encouraging results for women with PMOS on GLP-1s. Alongside significant weight loss, some women experience improved insulin sensitivity, lower androgen levels, more regular menstrual cycles and even a return of ovulation.
“There is nothing easy about living with PCOS and you only know that if you’ve been through it yourself.”
Megan Rappa
In one trial, obese PMOS patients on metformin had a 28.6% success rate getting pregnant before IVF. When they took both metformin and liraglutide (sold under brand names Victoza and Saxenda), the pregnancy rate climbed to 85.7% — despite both groups losing similar amounts of weight.
“That gap suggests GLP-1s may act directly on the ovary, not just indirectly through weight loss, which is a meaningful distinction for patients to understand,” Merhi said.
The difference can be dramatic for some women. Online communities dedicated to PMOS are filled with thousands of firsthand accounts documenting improvements in weight, insulin resistance, menstrual cycles and energy levels.
After Rappa saw an endocrinologist who put her on Zepbound, she lost 56 pounds — and that was the tip of the iceberg.
“I’ve found myself regaining energy that I didn’t even recognize I had lost,” she said. “My symptoms have become more mild, my bloodwork has improved and I’ve also seen such an upgrade in my day-to-day life.”
Stanfield also started taking a GLP-1 two and a half years ago. Initially, she lost about 20 pounds, but what happened afterward has been even more valuable: Her cravings and “food noise” have “quieted significantly.”
“I don’t necessarily view the medication as a ‘weight loss drug’ anymore,” she said. “For me, it’s become a long-term tool for managing a persistent metabolic condition.”
Paying up the wazoo
As demand rises, access remains uneven. No drugs — not just GLP-1s — are FDA-approved for PMOS, so every prescription is off-label. That can make insurance coverage tricky.
“Insurers anchor coverage to the FDA label,” said Botta, who is also co-founder and president of Sesame, a cash-pay healthcare marketplace. “A woman with PCOS gets covered only if she qualifies through another door, such as a diabetes diagnosis or BMI-based obesity criteria.”
The result? Most women are paying for these drugs — sometimes more than $1,000 a month — in cash.
Manufacturer direct-to-consumer channels now offer deep discounts, sometimes as low as $299 a month. “But it’s still a means test on a medication for a condition that affects 1 in 10 women,” Botta said.
It’s also likely a lasting commitment.
“We’re seeing that many of the benefits — weight loss, improved cycles — can reverse after discontinuation,” Merhi said. “That raises questions about whether this is a long-term therapy or something women would need to stay on indefinitely.”
Should GLP-1 drugs become a standard PCOS treatment?
For now, most professional guidelines still recommend lifestyle changes, weight management when appropriate and medications such as metformin as first-line options for many women with PMOS.
Even so, attitudes are beginning to shift. As evidence surrounding GLP-1 drugs for PCOS continues to build, more endocrinologists are viewing them as a promising option for women with obesity, insulin resistance or metabolic complications that haven’t responded to conventional therapies.
The momentum is undeniable.
“If the ongoing clinical trials confirm what we’re seeing in practice, GLP-1s could become a legitimate first-line option for women with metabolic PCOS who haven’t responded to metformin or lifestyle changes,” Merhi said.
The biggest misconception, though, is that GLP-1s are a quick fix.
“I think we’re slowly moving away from the stigma of GLP-1s serving as the ‘easy way’ to lose weight,” said Rappa. “There is nothing easy about living with PCOS and you only know that if you’ve been through it yourself.”
