GLP-1 Medications: Side Effects Women Should Know

GLP-1 Medications: Side Effects Women Should Know (and How to Navigate Them)

GLP-1–based medicines (like semaglutide and tirzepatide) can be powerful tools for metabolic health, weight management, and even sleep apnea, but like any therapy, they come with potential side effects. Understanding what’s common vs. serious, who’s at higher risk, and how to prevent problems helps you use these meds safely and confidently.

The most common, usually temporary side effects

Nausea, vomiting, diarrhea, constipation, abdominal pain, reflux/bloating, fatigue, headache. These are dose-related, most noticeable during dose escalation, and often improve as your body adapts. Slow titration, smaller/frequent meals, hydration, and pausing at a dose if symptoms flare can help.
The GI effects aren’t always considered “side effects” but instead are associated with “gut health” dysfunction or leaky gut. If your gut is unhealthy and unbalanced, you can gain weight and have metabolic dysfunction that prevent weight loss. An unhealthy gut may be the primary reason for your weight and hormone issues. Symptoms of diarrhea, constipation, bloating, acid reflux, gas and abdominal discomfort are actually symptoms of disruptions of gut health and balance magnified by use of GLP injections and not the GLP medication itself. We can tell the difference and we can help.
Muscle loss- loss of muscle is one of the more serious side effects not discussed and can have huge consequences. Loss of muscle is aging and can cause serious weight gain in the future when the medication is stopped. Muscle loss occurs at higher doses and in most cases, higher doses are used with clinicians or companies that prescribe but do not monitor or coach their clients. Muscles the key to long term weight loss success and prevention of aging.

GLP medications are a tool to be used under supervision and not misused as some companies prescribe without supervision. Coaching is a huge part of your weight loss plan and long term success.

Below are the serious side effects that clients must take seriously.

GI effects we take seriously (but are uncommon)

Pancreatitis. Severe, persistent mid-upper abdominal pain (often radiating to the back) with vomiting needs urgent evaluation. Risk appears low overall, but has been reported; rapid weight loss and dehydration may contribute. PMC Cleveland Clinic Journal of Medicine
Gallbladder/biliary disease. GLP-1s are associated with a higher risk of gallstones and cholecystitis, especially at higher doses, longer duration, and when used for weight loss. Rapid fat loss itself also raises risk. Watch for right-upper-quadrant pain, fever, jaundice. JAMA Network PMC
Gastroparesis / delayed gastric emptying and ileus (bowel blockage). GLP-1s slow stomach emptying; rare cases of gastroparesis and ileus have been reported and are now reflected in labeling. Concerning signs: severe bloating, persistent vomiting, inability to pass gas or stools. Seek care. FDA Access Data PMC

Eye and kidney considerations

Diabetic retinopathy (DR) worsening in some with existing DR. In people with type 2 diabetes and pre-existing DR, rapid A1c drops on semaglutide were linked to more DR complications in early trials; careful monitoring is advised if you already have DR. New England Journal of Medicine PMC
Kidneys. Rare acute kidney injury has been described—often in the setting of severe GI fluid losses. Protect yourself by staying hydrated, holding the dose during severe vomiting/diarrhea, and checking labs if you have CKD. PMC kidneymedicinejournal.org

Thyroid, mood, and heart-rate notes

Thyroid C-cell tumor warning (boxed). In rodents, GLP-1s increased C-cell tumors; avoid if you or family have medullary thyroid carcinoma (MTC) or MEN2. This is a class labeling and appears on semaglutide/tirzepatide products. FDA Access Data+1
Mood. Wegovy carries a warning to monitor for suicidal ideation; however, regulators (FDA/EMA) report no causal link to date. We still screen and monitor—especially if you have a history of depression/anxiety. U.S. Food and Drug Administration FDA Access Data
Slight heart-rate increases can occur; we keep an eye on this in visits. FDA Access Data

Surgery and procedures: don’t skip this

Because GLP-1s delay gastric emptying, there’s been concern about aspiration during anesthesia. Latest multi-society guidance says most low-risk patients can continue their GLP-1s before elective surgery, while higher-risk patients may need individualized plans. Always tell your anesthesiologist. American Society of Anesthesiologists+1

Who should be extra cautious?

Personal/family history of MTC or MEN2 (contraindication). FDA Access Data
Active gallbladder disease, history of pancreatitis, significant gastroparesis/IBD, advanced CKD, or proliferative diabetic retinopathy—you’ll need a personalized plan and closer monitoring. FDA Access Data PMC New England Journal of Medicine

Practical ways to reduce side effects

Start low, go slow. Don’t rush titrations; hold a dose if symptoms flare. FDA Access Data
Protein + produce, small portions. Greasy, large meals worsen nausea.
Hydrate + electrolytes. Especially during GI symptoms. Cleveland Clinic Journal of Medicine
Know red flags (severe abdominal pain, persistent vomiting, jaundice, vision changes) and call your clinician. FDA Access Data JAMA Network
Use only FDA-approved products. Avoid compounded or “research-only” versions sold online; the FDA warns of quality and dosing risks. U.S. Food and Drug Administration

Our NuBloom perspective

We use GLP-1s when appropriate as part of a whole-person plan – addressing sleep, stress, gut health, protein intake, and resistance training to protect muscle, mood, and metabolism. The goal isn’t just the scale – it’s resilience and wellness. Learn what to expect with NuBloom.

Book your free Bloom session today to find out how we can help you.

References

U.S. Food & Drug Administration. Ozempic (semaglutide) Prescribing Information (2023 label). Sections on common GI adverse reactions; warnings include gallbladder disease and postmarketing reports. FDA Access Data
U.S. Food & Drug Administration. Wegovy (semaglutide) Prescribing Information (2024 update). Warnings and precautions include diabetic retinopathy complications, heart-rate increase, suicidal ideation, and pulmonary aspiration with anesthesia. FDA Access Data
U.S. Food & Drug Administration. Zepbound (tirzepatide) Prescribing Information (Feb 7, 2025). Boxed warning on thyroid C-cell tumors; contraindicated in MTC/MEN2. FDA Access Data
He L, et al. Association of GLP-1 Receptor Agonist Use With Risk of Gallbladder or Biliary Diseases: Systematic Review and Meta-analysis. JAMA Intern Med. 2022. Increased risk, especially with higher doses/longer duration/weight-loss use. JAMA Network
Marso SP, et al. Semaglutide and Cardiovascular Outcomes in Type 2 Diabetes (SUSTAIN-6). N Engl J Med. 2016. Signal for increased diabetic retinopathy complications with rapid A1c reduction in those with existing DR. New England Journal of Medicine
Vilsbøll T, et al. Semaglutide, HbA1c Reduction and Diabetic Retinopathy: Post-hoc Analyses of SUSTAIN. Diabetes Obes Metab. 2018. Clarifies relationship between rapid glycemic improvement and DR events. PMC
Leehey DJ, et al. Acute Kidney Injury Associated With Semaglutide: Case Reports. Kidney Med. 2021. Highlights AKI in the setting of severe GI fluid losses/CKD. kidneymedicinejournal.org
Cleveland Clinic Journal of Medicine. Glucagon-Like Peptide-1 Receptor Agonists and Pancreatitis. 2025. Review of pancreatitis risk in context of weight loss and dehydration. Cleveland Clinic Journal of Medicine
EMA PRAC. Meeting Highlights (Apr 8–11, 2024): No causal link found between semaglutide and suicidal thoughts based on large EHR study; continue monitoring. European Medicines Agency (EMA)
U.S. FDA. Update on Evaluation of Suicidal Thoughts/Actions in Patients Taking GLP-1 Medicines. Jan 30, 2024. Preliminary review does not suggest a causal link. U.S. Food and Drug Administration
Sodhi M, et al. Risk of Gastrointestinal Adverse Events With GLP-1 Agonists Used for Weight Loss. JAMA 2023. Signal for gastroparesis, biliary disease, pancreatitis; absolute risks remain low. PMC
American Society of Anesthesiologists & Multi-Society Guidance. Most Patients Can Continue GLP-1s Before Elective Surgery (Oct 29, 2024). Updated approach to aspiration risk. American Society of Anesthesiologists
American Society of Anesthesiologists. Consensus-Based Guidance on Pre-op GLP-1 Management (June 29, 2023). Initial suggestion to hold prior to procedures; superseded/updated for many patients by 2024 multi-society guidance. American Society of Anesthesiologists
U.S. FDA. Concerns With Unapproved/Compounded GLP-1 Products Used for Weight Loss (updated Aug 2025). Advises against purchasing unapproved/“research-only” products due to quality/dosing risks. U.S. Food and Drug Administration

This content is for informational and educational purposes only and is not intended to diagnose, treat, or replace professional medical advice. Always consult your healthcare provider before starting any new supplement, medication, or wellness program. NuBloom provides access to licensed medical professionals through individualized programs, but blog content does not establish a provider-patient relationship. Bloom wisely.