Metabolic, hormonal, and reproductive effects of GLP-1 receptor agonizts in hyperandrogenic insulin-resistant women: a systematic review.
Mariam Sherif Mohamed, Ahmed Farrag, Panayoti Bachkangi
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In 30 seconds
This systematic review evaluated GLP-1 receptor agonists for metabolic, hormonal, and reproductive outcomes in adult women with hyperandrogenic insulin-resistant conditions, principally polycystic ovary syndrome and HAIR-AN syndrome. It included randomized trials, observational studies, and case series, reflecting a heterogeneous evidence base. Metabolic responses were more consistent and robust than endocrine effects. Menstrual regularity and other reproductive outcomes were reported inconsistently, so the review could not establish a fertility-related benefit. Evidence in severe phenotypes was limited but suggestive of benefit; no pooled quantitative effect estimate was reported.
Key findings
- Metabolic outcomes showed more consistent and robust responses to GLP-1 receptor agonists than endocrine outcomes.
- Menstrual regularity was variably reported, with inconsistent improvement across studies.
- Evidence in severe phenotypes such as HAIR-AN syndrome was limited but suggestive of clinical benefit.
Why it matters
The review distinguishes the comparatively consistent metabolic signal from less certain hormonal and reproductive effects. This helps frame expectations: improvement in metabolic outcomes does not establish fertility benefit or reliable changes in menstrual function. The mixed study designs and outcome reporting also underscore the need to interpret findings across these conditions cautiously.
What to keep in mind
The evidence base combined randomized trials, observational studies, and case series, with heterogeneity in populations, interventions, and outcome reporting; evidence in severe phenotypes was limited.