This article covers guidance for people using GLP-1 weight loss medications — including Zepbound® (tirzepatide), Wegovy® (semaglutide), and Foundayo™ (orforglipron) — who are pregnant, planning a pregnancy, breastfeeding, using contraception, or taking hormone replacement therapy (HRT).
Read this article if you have questions about how GLP-1 weight loss medications interact with oral contraceptives, how long to wait before trying to conceive, or whether GLP-1 medications can affect HRT.
Can I use Zepbound®, Wegovy®, or Foundayo™ while pregnant?
No. Zepbound® (tirzepatide), Wegovy® (semaglutide), and Foundayo™ (orforglipron) must not be used during pregnancy. If you become pregnant while taking any of these GLP-1 weight loss medications, stop taking the medication immediately and contact your physician and the ZipHealth Clinical team.
Do I need to use contraception while taking Zepbound®, Wegovy®, or Foundayo™?
If you are of childbearing potential and sexually active, you should use effective contraception while taking Wegovy® (semaglutide), Zepbound® (tirzepatide), or Foundayo™ (orforglipron).
If you are taking Wegovy® (semaglutide):
Wegovy® does not affect how your body absorbs oral contraceptive pills. You can use oral contraceptive pills, an IUD, a hormonal implant, or a barrier method such as condoms to prevent pregnancy while taking Wegovy®.
If you are taking Zepbound® (tirzepatide) or Foundayo™ (orforglipron):
Zepbound® and Foundayo™ can affect how your body absorbs oral contraceptive pills because these medications slow down digestion. If you currently take oral hormonal contraceptives and are starting Zepbound® or Foundayo™:
Switch to a non-oral contraceptive method such as an IUD or hormonal implant, OR
Add a barrier method such as condoms for at least 4 weeks after starting Zepbound® or Foundayo™ and for at least 4 weeks after each dose increase.
Important: If you experience severe diarrhea lasting more than 24 hours, or vomiting within 3 hours of taking an oral contraceptive pill while on any GLP-1 weight loss medication, you may need to take another pill. Contact your physician or pharmacist for advice.
Do Zepbound®, Wegovy®, and Foundayo™ affect the oral contraceptive pill?
Wegovy® (semaglutide): Wegovy® does not affect how your body absorbs oral contraceptive pills. Oral contraceptive pills, an IUD, a hormonal implant, or a barrier method such as condoms can all be used alongside Wegovy®.
Zepbound® (tirzepatide) and Foundayo™ (orforglipron): Zepbound® and Foundayo™ can affect how your body absorbs oral contraceptive pills because they slow down digestion. If you take oral hormonal contraceptives, switch to a non-oral contraceptive method such as an IUD or implant, or add a barrier method such as condoms:
For 4 weeks after starting Zepbound® or Foundayo™
For 4 weeks after each dose increase of Zepbound® or Foundayo™
If you experience severe diarrhea lasting more than 24 hours, or vomiting within 3 hours of taking your oral contraceptive pill while taking any GLP-1 weight loss medication, contact your physician for medical advice.
I am planning to become pregnant. What should I do if I am taking Zepbound®, Wegovy®, or Foundayo™?
If you are planning to become pregnant, stop your GLP-1 weight loss medication before trying to conceive. The recommended waiting period after your last dose is:
Wegovy® (semaglutide): Wait at least 2 months after your last dose before trying to conceive.
Zepbound® (tirzepatide): Wait at least 1 month after your last dose before trying to conceive.
Foundayo™ (orforglipron): Wait at least 1 month after your last dose before trying to conceive.
Contact ZipHealth to discuss stopping your weight loss medication and to ensure your records are updated.
Can I use Zepbound®, Wegovy®, or Foundayo™ while breastfeeding?
No. Zepbound® (tirzepatide), Wegovy® (semaglutide), and Foundayo™ (orforglipron) should not be used while breastfeeding. If you are breastfeeding and would like to discuss weight management options, contact the ZipHealth Clinical team.
Can GLP-1 weight loss medications cause bleeding while I am taking HRT?
Some people taking GLP-1 weight loss medications such as semaglutide (Wegovy®), tirzepatide (Zepbound®), or orforglipron (Foundayo™) may notice changes in vaginal bleeding while also using hormone replacement therapy (HRT). Although this is increasingly observed, official clinical guidance on this interaction is still limited.
These changes may occur because GLP-1 weight loss medications slow down digestion, which can affect how your body absorbs hormone treatments — particularly HRT taken as oral tablets, including oral progestogens. There does not appear to be the same interaction with hormone patches or intrauterine devices such as the Mirena coil. Weight loss and other body changes related to GLP-1 treatment may also play a role.
While this type of bleeding is usually not serious, tell your doctor if you experience new, heavy, or ongoing bleeding while taking a GLP-1 weight loss medication and HRT. Your doctor can check for other causes, suggest adjusting your HRT, or carry out further tests if needed.
If you still need help after reviewing the information above, additional assistance is available.