July 14, 2026

The Definitive Guide to GLP-1 Medications

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Have you heard about GLP-1 injections but weren't sure how they actually work?

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Did you think these medications were only useful for weight loss?

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If the answer is yes — this guide is for you.

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GLP-1 medications come up constantly in perimenopause and menopause conversations, since the metabolic shift that comes with declining estrogen overlaps with exactly what these medications treat.

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However, most women have never been walked through what they actually do, how the options differ, or what to expect while starting one. This guide breaks it down for you.

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What These Medications Actually Are

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GLP-1 (glucagon-like peptide-1) medications mimic a hormone your gut already makes after eating. They slow how fast your stomach empties, signal fullness to your brain, and improve how your body responds to insulin.

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Tirzepatide goes a step further: it acts on both the GLP-1 and GIP receptors, which is part of why it tends to produce more weight loss than GLP-1-only medications.

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These started as diabetes drugs. Weight loss was a side effect researchers noticed and then deliberately developed further.

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Not Just for Weight Loss

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This class of medication has real effects on cardiometabolic health independent of the number on the scale. For example, tirzepatide is FDA-approved for obstructive sleep apnea in people with obesity, on top of its diabetes and weight-loss indications. Other studies on semiglutide have shown a 20% reduction in major cardiovascular events in people with overweight or obesity and existing heart disease (SELECT trial) and a 24% reduction in major kidney disease events by 24% in people with type 2 diabetes and chronic kidney disease (FLOW trial).

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All of these are direct effects on the heart, kidneys, and metabolism — not just downstream benefits of losing weight.

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The Three GLP-1 Medications You Should Know About

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Liraglutide (brand names include Saxenda, Victoza)

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How it's taken: Injected once daily, under the skin.

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Oral option: Not available, injectable only.

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What to expect: The oldest of the three, and generally the mildest in terms of weight loss: average results in trials were in the 5–7% range. Its shorter half-life means side effects can resolve between doses rather than building up over a week, but daily injections are a real adherence tradeoff for many patients.

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Semaglutide (brand names include Ozempic, Wegovy)

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How it's taken: Injected once weekly, under the skin.

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Oral option: Yes. Oral semaglutide (Rybelsus) has been available for type 2 diabetes since 2019. A higher-dose oral tablet specifically for weight management was more recently approved.

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What to expect: Average weight loss in trials has ranged roughly 10–18% depending on the study and dose, generally reached over many months, not weeks.

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Tirzepatide (brand names include Mounjaro, Zepbound)

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How it's taken: Injected once weekly, under the skin.

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Oral option: Not currently available, injectable only as of this writing.

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What to expect: The most effective of the three for weight loss in head-to-head data: a direct trial comparing tirzepatide to semaglutide found 20.2% average weight loss with tirzepatide versus 13.7% with semaglutide over 72 weeks. Individual trials of tirzepatide alone have shown results up to 22.5% at the highest dose.

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Side Effects

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All three share the same side effects: nausea, vomiting, diarrhea, and constipation. These are most noticeable during the dose-escalation phase and tending to improve as your body adjusts.

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Tolerance depends on the individual: some patients do better on one than another for reasons that aren't fully predictable, which is part of why we sometimes try a different option if the first one doesn't sit well with you.

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What to Expect With Weight Loss Timing

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Don't expect much in the first few weeks. Doses start low and increase gradually: this is done to help reduce side effects, not to produce results yet.

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Real weight loss typically builds over months, and the maximum effect depends on which medication you're on. For example, liraglutide tends to plateau earliest and lowest, semaglutide further out, and tirzepatide generally produces the most weight loss (but also takes longer to get there).

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Where This Connects to Menopause

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The hormonal changes from menopause include declining estrogen, slower insulin sensitivity, a tendency toward more belly fat, and rising cardiovascular risk. This is exactly the territory these medications work in. For some patients, a GLP-1 alongside hormone therapy addresses both the symptom and the underlying metabolic shift behind it.

Want to Talk Through Whether This Is Right for You?

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Book a free 15-minute intro call with Gliss Wellness — no referral, no waiting room, just a real conversation with an OB/GYN. Click here to get started.

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