A large Danish case-control study using national health registers found that women who used hormonal contraception were more likely to later initiate semaglutide therapy. All contraceptive patterns examined were associated with higher rates of semaglutide use, with adjusted hazard ratios ranging…
A new study from Denmark has revealed a significant association between hormonal contraception use and the subsequent initiation of the GLP-1 receptor agonist semaglutide. The research, published in JAMA Network Open, examined data from Danish health registers spanning nearly three decades. The findings indicate that women who had used any form of hormonal contraception were more likely to start semaglutide therapy compared with women who had never used such contraceptives.
The researchers conducted a nested case-control study using comprehensive Danish health registers. They identified all females aged 12 to 49 years who filled their first semaglutide prescription between January 1996 and December 2023. To ensure the analysis focused on new users, only women with no prior use of glucose-lowering drugs were included. The date of the first semaglutide fill served as the index date for each case.
Each semaglutide user was matched by birth year to 10 control participants who had never used glucose-lowering drugs. A total of 22,694 cases and 229,640 matched controls were included, yielding a study population of 249,634 participants. The median age of the participants was 37 years, with an interquartile range of 30 to 44 years. Hormonal contraception use was summarized based on the chronological order of contraceptive prescriptions filled from age 12 or study entry up to the index date.
The analysis examined various patterns of hormonal contraception use. All patterns were associated with semaglutide initiation compared with women who had no hormonal contraceptive use. For patterns involving a single contraceptive type, the adjusted hazard ratios varied. Combined oral tablets showed an aHR of 1.42 95% CI, 1.34 to 1.51 , while progestin-only intrauterine devices had an aHR of 1.63 95% CI, 1.46 to 1.82 .
When women had used two or more contraceptive types, the associations were stronger. The pattern of combined oral tablets followed by progestin-only oral tablets gave an aHR of 1.64 95% CI, 1.47 to 1.82 . Other patterns involving multiple contraceptive types showed the highest aHR at 2.11 95% CI, 1.97 to 2.25 . Adjustment for body mass index attenuated the associations but did not eliminate them, indicating that BMI was not the sole driver.
The researchers performed subgroup analyses to test the consistency of the findings across different demographic and clinical factors. These subgroups included age, education level, income, parity, immigrant status, and the specific semaglutide type used. The associations remained consistent across most patterns in these subgroups, strengthening the credibility of the overall finding.
However, the authors caution that this was an observational case-control study, and causality cannot be established. The association between hormonal contraception and subsequent semaglutide use may be influenced by unmeasured confounding factors. The study’s authors, led by Bager MD, call for further research into the underlying reasons why women may move from contraceptive management to pharmacologic weight management.
These findings highlight that a woman’s contraceptive history may serve as a predictor for future GLP-1 receptor agonist use. Given the growing use of semaglutide among women of reproductive age, understanding the factors that drive its initiation is clinically relevant. The study opens the door to exploring how reproductive health experiences, such as contraceptive choices, could inform weight management strategies.
The article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License. The publication also invites readers to rate the potential impact of the content on patient outcomes, though at the time of reporting no votes had been cast.
Peptides referenced: Semaglutide, GLP-1.
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