Fears about ‘Ozempic babies’ show how woeful women’s health care is

by Mary McNamara

The historic failure of medical research to acknowledge that women’s bodies differ from men’s has a new catchphrase: Ozempic babies.

According to recent reports, all of them anecdotal and many of them on TikTok, off-label use of diabetes drugs including Ozempic, Wegovy and Mounjaro for cosmetic weight loss has, in some cases, apparently resulted in unexpected pregnancy.

For women dealing with infertility issues, this can be cause for celebration; for those who are actively trying to avoid pregnancy by taking birth control pills, the exact opposite.

Doctors meanwhile are scrambling to figure it out. Pregnancy in previously infertile women taking semaglutides including Ozempic may, some surmise, simply be a result of weight loss itself — obesity can lead to hormone imbalances that make pregnancy difficult to achieve or sustain. Mounjaro and Zepbound, on the other hand, are tirzepatide, which may interfere with how medications are absorbed, rendering birth control pills less effective.

“May” being the operative word; no one appears to know for sure. Everyone recommends that women who want to become pregnant should stop taking these drugs at least two months before trying, but apparently there have been no long-term studies on the impact of these drugs on birth control or female fertility.

Cool, cool, cool. Just what women need as their access to abortion, birth control and other aspects of reproductive health care is being severely restricted across the country — a “miracle” diet supplement that can result in an unwanted pregnancy. The long and anguished drives to states with laws not rooted in the 1800s will take the pounds right off.

The fact that no doctor anywhere is recommending Ozempic or Mounjaro as a fertility treatment tells you everything you need to know. And though it would be lovely to think that everyone who is using semaglutides and tirzepatide for weight loss has consulted with a physician about all the potential risks and side effects, in the real world, many people are just ordering this stuff online.

Both the Mounjaro and Zepbound websites and packaging include, among a long list of potential side effects, instructions that those who take oral contraception speak with their health care providers, as “birth control pills may not work as well while using” either medication. But that messaging has been far from prominent in the cultural conversation about a potential world without obesity.

Then again, women are quite used to having their bodies and health be the subject of great political debate and very little medical research.

As a result of the Thalidomide tragedy, in which an anti-nausea medication given to pregnant women in the 1950s and 60s resulted in thousands of babies with birth defects, women of childbearing age were excluded from many clinical trials unless they had a life-threatening condition. In 1993, Congress passed a law requiring that women and minorities be included in clinical research. But in many studies, the male body remains the baseline; female test subjects remain the minority even in studies of problems that affect them more than men, including heart failure.

Conditions that predominantly affect men also receive more attention and funding than those that affect women: Despite ranking fifth in lethality among cancers, for instance, ovarian cancer comes 12th in terms of the resources devoted to it.

Even when dealing with female fertility, which currently obsesses so many conservatives in this country, the research has fallen short.

After more than a decade of women being encouraged to extend their fertile years by freezing their eggs (at great physical and financial expense), a 2023 study from the New York University Langone Fertility Center revealed that, on average, a frozen egg has only a 38% chance of producing a living baby. The odds are better the younger the woman is, but most women freeze their eggs so they can have children after their fertility begins to wane. So much for beating the biological clock, as promised by a multimillion-dollar industry that promoted its technologies in part as a way for women to avoid detrimental career disruptions.

(Because, of course, it is women’s bodies that should change to accommodate work, not the American workplace, with its lack of subsidized childcare and draconian parental leave policies.)

According to the same NYU study, frozen embryos have a slightly higher success rate than frozen eggs. But the recent ruling by the Alabama Supreme Court that a frozen embryo is legally a child, and therefore cannot be destroyed, has made that a more perilous option.

When women’s bodies become incapable of bearing children, forget it. I mean, literally forget it. In 2004, one portion of a Women’s Health Initiative study on the efficacy of hormone replacement to relieve symptoms of menopause was stopped after early data suggested an increased risk of stroke, pulmonary embolism and breast cancer.

As a result, menopausal hormone therapy (MHT) was shelved by many doctors and rejected by many fearful women.

Twenty years later, a WHI follow-up reveals that for women under 60, those risks were greatly exaggerated. WHI now considers the original study flawed — it focused mainly on women over 60 and used only one form of oral hormone replacement. Recent studies reveal that women under 60 receiving dermal treatment, through gel or patch, showed no greater risk of stroke and minimal increased risk of breast cancer.

More than 2 million women enter menopause each year. Which means that for 20 years, many of them have been suffering terrible symptoms, including hot flashes, migraines, mood swings, brain fog and insomnia, that could have been greatly lessened by MHT.

Twenty years!

But please, give us another commercial for drugs that treat erectile dysfunction or male-pattern baldness.

I suppose we should be grateful they are researching it at all — most studies on aging (as in 99%) do not factor in menopause. Which is like researching weather without factoring in rain. Menopause has only recently begun to be dealt with as an actual treatable medical condition as opposed to, you know, women’s lot in life.

Like, apparently, getting unexpectedly pregnant when you’re just trying to lose some weight.

Mary McNamara is a culture columnist and critic for the Los Angeles Times.