GLP-1 agonists (e.g. Mounjaro) and contraception or HRT

What are GLP-1 agonists?

GLP-1 agonists are medicines like tirzepatide and semaglutide. They might have other brand names too such as Mounjaro, Ozempic or Wegovy. These medicines can only be given by a doctor or nurse. They are used for people with type 2 diabetes or to help with losing weight. They work by making food leave the stomach more slowly. You may currently be prescribed one of these on the NHS for type 2 diabetes, or are purchasing it privately for weight loss.

I am taking the pill. Will using a GLP-1 agonist affect my contraception?

This depends on the type of GLP-1 agonist that you are using.

If you are using tirzepatide (Mounjaro), you should use condoms along with your pill for four weeks after you start the medicine and for four weeks after any dose increase. This is because tirzepatide works a bit differently from other similar medicines. You might also think about using a different type of contraception that isn’t a pill while on tirzepatide.

For other medicines like semaglutide, exenatide, liraglutide, dulaglutide, or lixisenatide, there is no proof that they make the pill less effective.

I have diarrhoea and vomiting with my GLP-1 agonist, and I take the contraceptive pill, what should I do?

Diarrhoea and vomiting can happen when taking GLP-1 agonists and might make the pill less effective. If you vomit within three hours of taking your pill, or have bad diarrhoea for more than a day, follow the guidance for missed pills. If diarrhoea or vomiting continues, think about using a different type of contraception that isn’t a pill, or use condoms as well.

What about non-oral methods of contraception e.g. the coil, implant, injection, patch or ring, could these be affected by GLP-1 agonists?

GLP-1 agonists do not affect contraception methods that aren’t pills. So, it’s safe to use these other options without any extra precautions when taking a GLP-1 agonist.

I am planning to switch from one type/brand of GLP-1 to another, does the contraception advice remain the same?

If you are changing to tirzepatide (Mounjaro) from any other GLP-1 agonist, use condoms for four weeks after switching and for four weeks after any dose increase. Keep taking your pill too. Or, you might want to switch to a different type of contraception that isn’t a pill while using tirzepatide.

I need emergency contraception and I’m taking a GLP-1 agonist; will it work?

We don’t know yet if GLP-1 agonists affect emergency contraception pills. The copper IUD (coil) is the best emergency contraception and isn’t affected by diarrhoea or vomiting. If you need emergency contraception, tell your healthcare provider about all the medicines you’re taking, including GLP-1 agonists.

Can I take a GLP-1 agonist during pregnancy?

It’s important to use good contraception when taking a GLP-1 agonist because these medicines shouldn’t be used if you’re pregnant. If you get pregnant while on these medicines, talk to your doctor. You should also stop taking GLP-1 agonists several weeks before trying to get pregnant. The table below shows how many weeks you should stop the medicine before planning a pregnancy for some GLP-1 agonists.

I’m on HRT and taking Mounjaro – what do I need to know?

If you are taking oral progestogen as part of your HRT (for example Utrogestan, Norethisterone, Medroxyprogesterone), then you need to be aware that tirzepatide (Mounjaro) may have an impact on the effectiveness of your HRT. This means your HRT might not protect your endometrium (womb lining) enough. Please contact the surgery to book an HRT review, as we may need to increase your dose or change you to a different form of medication.

If you do not take your HRT orally (for example, you use a patch, a gel or a Mirena coil instead of a tablet) then you do not need to worry.

FSRH patient information leaflet

Total Triage System Update December 2025

Unfortunately there is no GP based NHS service for Mounjaro injections in Sheffield yet. See the link below for more info:
NICE’s announcement on Tirzepatide (Mounjaro). Frequently asked questions for patients :: South Yorkshire I.C.B
When it does become available, to start with, it will only be for people with a BMI of over 40 and 4 obesity related medical conditions. 

You may be eligible for weight loss injections through a different pathway if you meet all the criteria. Please see this link for more info:
Oviva Tier 3 Weight Management Eligibility CriteriaBased on NICE guidance
Please note the BMI/medical condition info + that you have to have recently completed a "tier 2" program. 

A Tier 2 program is a service that provides support with dietary and exercise weight loss support. If you haven't done this you can self refer following this link: https://myclientgenius.com/self-referral/sheffield/new
They will inform us when you have completed the program and at that point, if you wish and still meet the criteria, we can refer you for injections.

South Yorkshire residents are being encouraged to return any unwanted medicines to a pharmacy.  

People are also encouraged to only order the medicines they need, check their medicines bag before they leave their pharmacy and to tell their GP if they no longer want/need a medication.  

These messages aim to reduce harm caused to the environment from medicines pollution as well as potential harm to pets and people at home, and to prevent medicines over-ordering and stockpiling.  

If unwanted and unneeded medicines are returned whilst still in the pharmacy those medicines can be safely re-used. 

Dr David Crichton, Chief Medical Officer, NHS South Yorkshire said: 

 “Returning unwanted medicines to a local pharmacy is a simple and effective action that can help to protect nature and ourselves.   

“When medications get flushed down a toilet or put in bins they can get into our soil and waterways and cause harmful pollution.  

“If you have unwanted medication you can return it to a pharmacy for safe disposal. 

“This includes any products with medication in them, such as creams, liquids, medicine bottles, used patches and inhalers.”   

“We would ask that patients only order the medications that they need.” 

Inhalers in particular, are incredibly important to dispose of correctly as they can leak greenhouse gasses long after the medication has been used. 

NHS South Yorkshire urges all residents to check their medicines supply before ordering more, and to check their medicines bags before leaving the pharmacy to help protect supply chains and our environment. 

For more information visit the NHS South Yorkshire Website: https://southyorkshire.icb.nhs.uk/your-health/south-yorkshire-medicine-waste 

We wanted to share some information that we have received from the Department of Health and Social Care on 19th July 2021:

Patient data from general practice has significantly contributed to the improvement of health and care services and treatments for many years. Patients rightly trust their GP to safeguard their data, a role that we know that all general practitioners take very seriously. This is why I am writing to share more information with you about how we are working to improve how this data is collected.

NHS Digital is making improvements to how data is collected from general practice, with a new framework for data extraction called the General Practice Data for Planning and Research (GPDPR) collection. You will have seen the announcement to pause the collection of this data, to provide more time to engage with GPs, patients, health charities and others, and to strengthen the plan. We are working in collaboration with a range of partners including the Royal College of General Practitioners (RCGP) and the British Medical Association (BMA). I want to reassure you that we have heard your concerns loud and clear and will continue to listen.

I am writing now to provide an update on the four key areas of work to strengthen the plan. We hope this will foster your trust in the system and provide a strong basis for you and your patients to participate in the scheme with confidence. Most importantly, I can confirm today that, while we are continuing to work on the infrastructure, and communication for the project, we are not setting a specific start date for the collection of data. Instead, we commit to start uploading data only when we have the following in place:

• the ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded;
• the backlog of opt-outs has been fully cleared; 
• a Trusted Research Environment has been developed and implemented in NHS Digital;
• patients have been made more aware of the scheme through a campaign of engagement and communication. In this letter each of these adjustments are set out, all of which are critical to the success and impact of the programme, including through better understanding of the huge benefits the programme will have to the NHS and to our ability to provide the best and safest possible care for patients.

Opt-outs:

We want to make the position around opt-out much simpler. While 1st September has been seen by some as a cut-off date for opt-out, after which data extraction would begin, I want to reassure you that this will not be the case and data extraction will not commence until we have met the tests. We are introducing three changes to the opt-out system which mean that patients will be able to change their opt-out status at any time:

- Patients do not need to register a Type 1 opt-out by 1st September to ensure their GP data will not be uploaded;

- NHS Digital will create the technical means to allow GP data that has previously been uploaded to the system via the GPDPR collection to be deleted when someone registers a Type 1 opt-out;

- The plan to retire Type 1 opt-outs will be deferred for at least 12 months while we get the new arrangements up and running, and will not be implemented without consultation with the RCGP, the BMA and the National Data Guardian.

Together, these changes mean that patients can have confidence that they will have the ability to opt-in or opt-out of the system, and that the dataset will always reflect their current preference. And we will ensure it is easy for them to exercise the choice to opt[1]out.

We will also ensure that the NHS Digital Data Protection Impact Assessment (DPIA) reflecting these changes to the programme is published well before data collection commences. A template DPIA for practice use will also be made available in good time to allow practices to complete it.

Data Security and Governance 

The Government has committed that access to GP data will only be via a Trusted Research Environment (TRE) and never copied or shipped outside the NHS secure environment, except where individuals have consented to their data being accessed e.g. written consent for a research study. This is intended to give both GPs and patients a very high degree of confidence that their data will be safe and their privacy protected. The TRE will be built in line with best practice developed in projects, such as OpenSAFELY and the Office for National Statistics’ Secure Research Service.

We are also committed to adopting a transparent approach, including publishing who has run what query and used which bit of data. We are developing a TRE which will meet our specific needs and act as “best in class”. We commit to only begin the data collection once the TRE is in place. Further, we will ensure that the BMA, RCGP and the National Data Guardian have oversight of the proposed arrangements and are satisfied with them before data upload begins.

I can also confirm that the previously published Data Provision Notice for this collection has been withdrawn.

Once the data is collected, it will only be used for the purposes of improving health and care. Patient data is not for sale and will never be for sale.

Transparency, communications and engagement

There has been a great deal of concern regarding the lack of awareness amongst the healthcare system and patients. We recognise that we need to strengthen engagement, including opportunities for non-digital engagement and communication. Since the programme has been paused, we have been developing an engagement and communications campaign, with the goal of ensuring that the healthcare system and patients are aware and understand what is planned, and can make informed choices. The public rightly look to and trust general practice - through a centrally driven communication campaign, with clear messages, we will seek to ensure that the introduction of this collection does not impose an additional burden on practices.

We are developing a communications strategy delivered through four phases.

• Listening - where we listen to stakeholders and gather views on how best to communicate with the profession, patients and the public and give them the opportunity to inform the development of the programme in areas such as opt-outs, trusted research environments and other significant areas;

• Consultation - a series of events where we can explain the programme, listen and capture feedback and co-design the information campaign;

• Demonstration - show how feedback is being used to develop the programme and shape communications to the healthcare system and the public;
• Delivery - of an information campaign to inform the healthcare system and the public about changes to how their GP data is used, that utilises the first three phases to ensure the campaign is accessible, has wide reach and is effective.

Data saves lives. The vaccine rollout for COVID-19 could not have been achieved without patient data. The discovery that the steroid Dexamethasone could save the lives of one third of the most vulnerable patients with COVID-19 – those on ventilators - could not have been made without patient data from GP practices in England. That insight has gone on to save a million lives around the globe. That is why this programme is so important.

The programme and I will be providing further information as the programme progresses.

In the meantime, if you have any questions, you can contact the programme at enquiries@nhsdigital.nhs.uk.

The NHS Digital web pages also provide further information at https://digital.nhs.uk/data[1]and-information/data-collections-and-data-sets/data-collections/general-practice-data-for[1]planning-and-research#additional-information-for-gp-practices.

Thank you for your continued support.

JO CHURCHILL

Parliamentary under Secretary of State for Primary Care and Health Promotion

Foxhill Medical Centre no longer has the facility to insert or change contraceptive Coils or Implants.

You will need to self-refer to Sheffield Sexual Health on 0114 226 8888 who will be able to direct you to a local service to meet your needs.

If your Coil is part of HRT/treatment of menopausal symptoms only, you will need to speak to a GP for a consultation.