Mounjaro® side effects in women: How they differ and how to manage them

You’ve probably heard of Ozempic^®—it’s widely used to manage type 2 diabetes and has gained lots of attention for its off-label weight loss use. But what about Mounjaro^®? It might not be as well known, but it works in a very similar way. 

Like Ozempic^®, Mounjaro^® is part of a group of medications called GLP-1 receptor agonists. It’s a once-weekly injection that helps regulate blood sugar and curb appetite by acting on your body’s natural hormone pathways. While it’s FDA-approved for type 2 diabetes, many providers also prescribe it off-label for weight management.

Here’s where things get interesting: Even though GLP-1 meds like Mounjaro^® offer similar benefits for most people, studies suggest women may experience the side effects differently. That’s likely due to factors like hormone shifts, body composition, and metabolism.

So what does that mean for you? Let’s break down how Mounjaro^® works, what to expect, and how to manage any side effects.

Why Mounjaro^® can lead to different side effects in women

Mounjaro^® (tirzepatide) works by mimicking two hormones—GLP-1 and GIP—to help regulate blood sugar, curb appetite, and slow digestion. These actions make it effective for weight loss and type 2 diabetes management, but they can also lead to uncomfortable side effects as your body adjusts. Nausea, vomiting, and other digestive issues are among the most common.

And women may be more likely to experience them.

Research suggests that women experience gastrointestinal (GI) side effects from GLP-1 medications like Mounjaro^® more often—and more intensely—than men. One large review found that women were twice as likely to report persistent nausea or vomiting on GLP-1s. But women may also see greater weight loss benefits. Studies show women lost an average of 25% of their body weight, compared to 18% for men over 72 weeks. They were also more likely to hit 5% and 10% weight loss milestones.

So, what’s going on?

Hormones may help explain why women respond differently to GLP-1 medications like Mounjaro®. In animal studies, estrogen increased GLP-1 activity in brain areas linked to nausea—especially during times of higher estrogen, like certain phases of the menstrual cycle.

Another study found that GLP-1 triggered stronger brain responses in females, particularly in areas that regulate appetite and reward. This could help explain why women may feel a bigger drop in appetite—and lose more weight—but also experience more side effects like nausea.  

Other side effects might be tied to rapid weight loss, which can temporarily lower estrogen levels. This shift may affect energy, mood, or menstrual cycle regularity—especially in women who are already sensitive to hormonal changes.

The most common side effects of Mounjaro^®

Most people taking Mounjaro^® experience similar side effects, especially when first starting the medication or during dose changes. Digestive symptoms like nausea or upset stomach are the most frequently reported, and they can happen to anyone, regardless of sex. 

Here are the side effects you can expect for different dosages, based on findings from clinical trials:

Symptom	Mounjaro® 5 mg	Mounjaro® 10 mg	Mounjaro® 15 mg
Nausea	12%	15%	18%
Diarrhea	12%	13%	17%
Vomiting	5%	5%	9%
Constipation	6%	6%	7%
Dyspepsia (indigestion)	8%	8%	5%
Stomach pain	6%	5%	5%

Other side effects women might experience while taking Mounjaro^® 

We’ve already covered how women tend to experience more digestive side effects like nausea and vomiting on Mounjaro^® compared to men. But women also report additional symptoms that seem to align with hormonal shifts or changes in body composition, especially during the first few months of treatment.

These aren’t officially recognized as sex-specific side effects in clinical trials, and research is still emerging. But early reports and observational data point to a few common patterns:

Hair loss or thinning

Some women notice that their hair feels thinner—or that they’re shedding more than usual—a few months after starting Mounjaro^® or another GLP-1 medication. Early research on semaglutide, the active ingredient in Ozempic^® and Wegovy^®, suggests women may be more prone to this side effect than men. Prioritizing protein at every meal can support muscle mass, skin elasticity, and hair health—especially during rapid weight loss.

Changes in the menstrual cycle

Some women also report changes to their period while taking Mounjaro^®. These changes can include irregular cycles, missed periods, or differences in flow. While there’s currently no strong evidence that GLP-1 medications directly cause these changes, rapid weight loss—which often occurs on Mounjaro^®—is known to affect hormone levels in women.

For most women, these shifts are temporary and tend to normalize as weight stabilizes. Still, tracking your cycle can help you spot patterns and share useful insights with your provider.

There’s also promising news for people with polycystic ovary syndrome (PCOS): Studies show that GLP-1 medications, including tirzepatide, may help regulate periods and improve ovulation in people with PCOS.

Changes in sexual function

While not widely reported, there’s at least one documented case where a woman experienced sexual side effects after starting tirzepatide. Her symptoms resolved when she stopped the medication and reappeared upon restarting, suggesting a possible link. Though more research is needed, it highlights the importance of monitoring not just physical but emotional and sexual well-being during treatment.

Mood or emotional shifts

Some women on Mounjaro^® report feeling different emotionally, possibly tied to the drug’s effects on the brain’s reward and emotion pathways. A study found that people using GLP-1 medications had a significantly higher risk of developing depression, anxiety, or suicidal thoughts compared to non-users—especially women. But it’s important to note that the FDA reviewed these concerns and found no consistent evidence linking GLP-1 medications to suicidal ideation or severe mood disorders. Still, if you notice any emotional changes, it’s worth tracking your symptoms and bringing them up with your provider to ensure you get the right support.

Does Mounjaro^® affect female fertility?

There isn’t strong evidence that Mounjaro^® directly impacts fertility positively or negatively. But because it influences how your body regulates insulin, appetite, and weight, it may indirectly affect reproductive health, especially for people with PCOS, where those factors play a major role.

Early research suggests that the weight loss resulting from GLP-1 medications like tirzepatide may help improve ovulation and menstrual regularity in people with PCOS, which could impact fertility. But Mounjaro^® hasn’t been studied extensively in people who are actively trying to conceive.

It’s also important to know that GLP-1 medications aren’t safe to use during pregnancy. You need to stop taking Mounjaro^® at least two months before trying to conceive.

If pregnancy is on your radar—now or in the near future—talk with your doctor. 

Does Mounjaro^® affect birth control?

Mounjaro^® can affect how your body absorbs birth control pills, especially during the first month or after your dose goes up. Since tirzepatide slows down how quickly your stomach empties, it can make it harder for your body to absorb the hormones in the pill. Because of this, use a backup form of birth control, for 4 weeks after you start Mounjaro^® or after any dose increase.

If you do become pregnant while taking it, reach out to your doctor right away—they’ll help guide you through the safest next steps.

Managing side effects while taking Mounjaro^®

There aren’t any official rules about changing GLP-1 treatment based on sex, but some doctors do tweak things based on their experience and what people report. Here’s how to manage the most frequent side effects and other tips for identifying potential issues:

Symptom	What can help
Nausea	Try eating smaller, more frequent meals instead of large portions. Ginger tea, clear broths, and light snacks like crackers can help soothe your stomach.
Diarrhea	Focus on hydration and electrolyte balance. Avoid high-fat, fried, or dairy-heavy foods. Stick to gentle meals like plain rice, applesauce, or oatmeal until symptoms ease.
Vomiting	Stay hydrated with small sips of water or ice chips. Eat bland, easy-to-digest foods like toast or bananas. If vomiting is frequent or doesn’t improve, speak with your provider about adjusting your dose.
Constipation	Increase your fiber intake gradually with fruits, veggies, or whole grains. Drink plenty of water and stay active. A gentle over-the-counter stool softener can help if needed.
Dyspepsia (indigestion)	Try eating more slowly, avoiding rich or acidic foods, and elevating your head while resting. Light walks after meals may also help.
Stomach pain	Eat smaller meals, avoid carbonated drinks, and use a heating pad if needed. Persistent pain should be discussed with your provider.

Read more about the side effects of Mounjaro^® and how to manage them.

Severe side effects and warnings of Mounjaro^®

While the more common side effects of Mounjaro^®, like digestive issues, may happen more frequently in women, research has not shown any significant differences between genders for the rarer and more serious side effects. Still, it’s important to know what to look out for. If you experience any of the following symptoms, seek medical attention right away:

• Pancreatitis: Watch for severe stomach pain that may spread to your back, especially if it’s accompanied by persistent nausea or vomiting.
• Gallbladder problems: Symptoms may include upper abdominal pain, fever, yellowing of the skin or eyes (jaundice), or unusually light-colored stools.
• Kidney issues: Signs include swelling in the legs or ankles, reduced urination, fatigue, or difficulty breathing, particularly after vomiting or dehydration.
• Low blood sugar (hypoglycemia): This is more likely if you’re also taking insulin or sulfonylureas. Look out for shakiness, dizziness, confusion, sweating, blurred vision, or a fast heartbeat.
• Vision changes: Sudden shifts in eyesight, especially in people with type 2 diabetes, should be evaluated right away.
• Allergic reactions: Seek emergency care if you experience swelling of the face, lips, tongue, or throat; difficulty breathing; a rash; or severe itching.
• Thyroid tumors: GLP- medications have been linked to thyroid tumors in animal studies, but a link hasn’t been established in humans. See a doctor right away if you notice a lump or swelling in the neck or difficulty swallowing or breathing.

Who shouldn’t take Mounjaro^®?

Mounjaro^® isn’t the right choice for everyone, especially for people with certain health conditions that may raise the risk of serious complications. You should avoid using Mounjaro^® if:

• You or a family member has a history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
• You’re allergic to Mounjaro^® or any of its ingredients
• You’re pregnant, trying to become pregnant, or breastfeeding

Talk to your doctor about whether Mounjaro^® is right for you if:

• You’ve ever had pancreatitis.
• You have a serious digestive condition, such as gastroparesis, which slows stomach emptying. 

For the most up-to-date safety information, consult your healthcare provider or visit the official Mounjaro^® website.

What will happen when I stop Mounjaro^®?

If you’re thinking about stopping Mounjaro^®, it’s worth having a plan in place to help protect your progress. Whether you’re stepping back for health or personal reasons, how you transition off matters, especially if you’ve lost weight or managed blood sugar on the medication.

• Tapering may help your body adjust. Working with your provider to taper gradually can help avoid blood sugar spikes or sudden weight regain. One study found that people who tapered off GLP-1 medications maintained a stable weight for up to 26 weeks. Since Mounjaro^® stays in your system for about 25 days, easing off gives your body time to recalibrate.
• If you have diabetes, monitor your blood sugar closely. Your provider may adjust other medications. Using the Noom app can help you notice changes in appetite, energy, or mood along the way.
• Stick with the habits that got you here. Healthy routines—like daily movement, balanced meals, and stress management—can help you maintain results. Studies show that continuing these habits after stopping medication makes it easier to keep the weight off.

Mounjaro^® vs. other GLP-1 drugs: Comparing side effects

Research shows that women taking GLP-1 medications tend to experience more side effects than men, but the frequency of those side effects can also vary between medications. Let’s take a look at the different side effects that people report with different GLP-1 medications:

Medication (dose)	Nausea	Vomiting	Diarrhea	Constipation	Dyspepsia (indigestion)
Tirzepatide (15 mg) (Mounjaro®/ Zepbound®)	18%	9%	17%	7%	5%
Semaglutide (1 mg) (Ozempic®)	20%	9%	9%	3%	Not reported
Semaglutide (2.4 mg) (Wegovy®)	44%	24%	30%	24%	9%
Liraglutide (1.8 mg) (Victoza®)	20%	9%	12%	5%	7%
Liraglutide (3 mg) (Saxenda®)	39%	15%	21%	19%	9%
Dulaglutide (4.5 mg) (Trulicity®)	16%	9%	10%	Not reported	2%

What women should know before starting Mounjaro^®

If you’re thinking about trying Mounjaro^®, knowing what to expect is important. While common side effects like nausea or digestive discomfort are experienced by many, women may also notice changes tied to hormones, hair health, and weight patterns.

Fortunately, these effects are often manageable with the right strategies—things like adjusting meal timing, staying hydrated, and working closely with your healthcare provider to personalize your treatment plan. Support tools like Noom can also make a big difference. Noom’s science-backed approach to nutrition, behavior change, and mindset support can help you stay on track with healthy habits while managing the ups and downs of treatment.

Regular check-ins with your care team—and tools like Noom to guide your daily choices—can help you get the most out of Mounjaro^® while aligning with your long-term health goals. When you pair the right medication with sustainable lifestyle support, you’re setting yourself up for real, lasting results.

Note: Mounjaro®, Ozempic®, and Trulicity® are not FDA-approved for treating obesity or weight loss.