Let’s Talk About Weight Loss injections (GLP1’s) and Menopause

by | Nov 6, 2025 | Physical health, strength training, Weight Loss

Weight Loss Injections

I want to talk about weight loss injections. Recently, weight loss injections like Wegovy (semaglutide) and Mounjaro (tirzepatide) are becoming available on the NHS for some individuals with specific health conditions and a high BMI. These medications are typically prescribed within specialist weight management services, not routinely in GP practices, and often alongside a reduced-calorie diet and increased physical activity.

Eligibility criteria vary, but generally include a high BMI (e.g. 40 or more, or 35 with certain weight-related issues like type 2 diabetes, high blood pressure, or heart disease). The BMI threshold may be lower for individuals from some ethnic minority groups.

Weight loss injections are usually accessed through specialist NHS weight management services, not directly from GP practices. Patients meeting the criteria may be referred by their GP to these specialist services, which will assess their suitability for injections or other interventions like diet and exercise programs.

Wegovy (semaglutide) is available on the NHS as an option for weight management within specialist services, alongside a reduced-calorie diet and increased physical activity.

Mounjaro (tirzepatide) is being rolled out in a phased approach within primary care, with those with the highest clinical need (e.g. a BMI of 40 or more with four or more weight-related health problems) being the first to be eligible.

So what’s the difference between them and what do they do?

Both injections trigger the GLP-1 receptor in the brain that makes you feel fuller for longer and therefore less hungry. However, Mounjaro triggers two receptors in your brain. These are known as the GLP-1 and GIP receptors. Wegovy only works on the GLP-1 receptor. Since Mounjaro triggers two key receptors, it may be slightly more effective at controlling your appetite and therefore could help you to lose more weight

So basically, they turn off the ‘food noise’ that many people have and are highly effective at switching off hunger. But they do have certain side effects:

Common Side Effects:

  • Gastrointestinal Issues: Nausea, vomiting, diarrhea, constipation, and stomach pain are frequently reported.
  • General Side Effects: Dizziness, fatigue, and headache can also occur.
  • Injection Site Reactions: Some individuals may experience redness, swelling, or pain at the injection site.
  • Hair Loss: This can be a less common, but still reported, side effect.

More Serious Side Effects:

  • Pancreatitis:Inflammation of the pancreas, which can cause severe abdominal pain, is a potential but rare complication.
  • Gallstones:Weight loss can increase the risk of gallstones, which may require medical intervention if they cause issues.
  • Hypoglycemia (Low Blood Sugar):This is more likely in individuals with diabetes who are also taking weight loss injections.
  • Heart Problems:Some medications may cause a faster heart rate or increase blood pressure.

Weight Loss Injections and HRT

One other thing that you may not be aware of, is that they can interfere with ORAL HRT ! Weight loss injections, like those containing semaglutide (Wegovy) or tirzeppatide (Mounjaro), can impact the effectiveness of oral HRT due to delayed gastric emptying. This means that oral HRT medications, particularly progesterone tablets (Utrogestan), may not be absorbed as efficiently, potentially affecting the protection of the endometrium (lining of the womb). Here’s a more detailed breakdown:

  • Impact on Oral HRT: Weight loss injections, particularly GLP-1 agonists, can slow down stomach emptying, which can affect the absorption of oral medications, including HRT.
  • Progesterone Concerns: Oral progesterone, a component of some HRT regimens, is especially vulnerable to this reduced absorption.
  • Potential Risks: Inadequate absorption of progesterone can lead to breakthrough bleeding, irregular periods, and potentially increase the risk of endometrial cancer, especially in women with conditions like diabetes or PCOS.
  • Recommended Actions: If you are on oral HRT and considering weight loss injections, or already using them, contact your GP for a review. They may recommend switching to a non-oral form of HRT (like patches or gels) or adjusting your HRT dosage.

Weight Loss Injections and Lifestyle Changes

These medications work by suppressing appetite and slowing down gastric emptying, leading to a decrease in overall calorie consumption, which can result in muscle loss if not managed properly. Studies indicate that a significant percentage of weight lost on GLP-1 medications can be muscle mass. Rapid weight loss, especially from these injections, can contribute to sarcopenia, the age-related loss of muscle mass and strength. Muscle tissue is metabolically active, and losing muscle mass can slow down metabolism, potentially making it harder to maintain weight loss long-term. Therefore, it’s vitally important that you try and mitigate this by:

  • Prioritise Protein: Consuming adequate protein is crucial for preserving muscle mass while losing weight on these medications.
  • Engage in Strength Training: Incorporate regular strength and resistance training exercises to stimulate muscle growth and maintenance.
  • Maintain a Healthy Lifestyle: Ensure adequate sleep, manage stress, and stay hydrated to support overall health and muscle preservation.
  • Regular Monitoring: Consult with healthcare professionals to monitor muscle mass and overall health during weight loss treatment.

Beware of the GLP-1 Micro-Dose Sellers!

If you are not eligible for the NHS weight loss injections, you can always opt to pay privately. They usually cost between £130 – £300 a month. But PLEASE if you decide to do this, only purchase weight loss injections from reputable and regulated sources to avoid counterfeit or unsafe products. Look for clinics that offer comprehensive support, including consultations, coaching, and follow-up care.

Some people choose to use very small, carefully tailored doses of GLP-1 medicines to explore health benefits beyond weight loss. This approach, called personalised dosing, is not part of standard medical guidance either at this moment.

This is not how the drugs Wegovy (Semaglutide) and Mounjaro (Tirzepatide) were studied or approved, and doctors don’t recommend it as a long-term plan.

It is considered off-label/unlicensed; it may support things like metabolism, immune balance, brain health, and inflammation. It’s generally meant for people who are already in good metabolic health and want to fine-tune how their body handles stress and stays resilient. Currently no evidence exists for this.

The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) clearly states that GLP-1 medicines are not authorised for non-standard or cosmetic use, and they caution against unassessed dosing strategies.

Healthcare professionals stress that any dose adjustment should be done under medical supervision. Microdosing may sound appealing, but it risks undermining treatment and could introduce side effects that haven’t been studied.

Standard medical supervision is critical—dosing mistakes and side effects can still occur.

Prescriptions should only be obtained from registered professionals and dispensed by authorised sources to also avoid the risk of receiving falsified pens.

What about Coming off the Injections?

The guidance from NICE has been updated to say that when people come off the weight loss injections they need support for up to a year. Once the injections are stopped, the hunger comes back! Therefore support is needed to change these habits long time or the weight will just be regained. You have an opportunity while taking them to change your behaviour and habits, so that these can be established FOREVER!!

Want Help Establishing a Strength Training Programme?

If you are using or thinking of using weight loss injections, or you just want help starting a strength training programme, I offer 1:1 personal sessions to show you how to lift safely, effectively and progressively. These can take place in your home, in my private studio or in a gym. Once you have learned how to lift with good form and with a good understanding of the basics, you can continue alone with free resources that I can provide, depending on your needs. Click here to have a free chat!