Key takeaways:

• Women who used any type of hormonal contraception had higher odds for starting semaglutide than nonusers.
• The association between hormonal contraception and semaglutide use was consistent across all subgroups.

Women who use hormonal contraception may be more likely to initiate semaglutide, according to real-world data from Denmark.

In a nested case-control study presented at the European Association for the Study of Diabetes annual meeting and previously published in JAMA Network Open, nine different hormonal contraception use regimens were associated with increased odds for starting semaglutide (Ozempic/Wegovy, Novo Nordisk). Mille Dybdal Bager, MD, a PhD fellow at Steno Diabetes Center in Copenhagen, Denmark, said the findings highlight how healthcare professionals need to consider a woman’s full health history when prescribing hormonal contraception.

Data were derived from Bager MD, et al. Session SO 061. Presented at: European Association for the Study of Diabetes Annual Meeting; Sept. 28-Oct. 2, 2026; Milan.

“It’s about perceived weight change, it’s about a previous history of weight change and her clinical circumstances as well,” Bager said during a presentation. “We, as prescribers, also influence our patients a lot. When we see them at our clinic, they have, just by being there, increased chance of starting any therapy, hormonal contraceptives and semaglutide.”

Bager and colleagues collected data from 22,694 adolescent girls and women aged 12 to 49 years who used semaglutide for the first time. Semaglutide users were matched to 229,640 controls who never used the medication. Hormonal contraception use was collected from the Danish National Prescription Registry.

Women using any type of hormonal contraception were more likely to begin semaglutide than those who never used hormonal contraception. After adjusting for BMI, odds for semaglutide initiation were increased with the combined tablet (adjusted HR = 1.43; 95% CI, 1.29-1.59), progestin-only tablet (aHR = 1.52; 95% CI, 1.21-1.9) and progestin-only intrauterine device (IUD; aHR = 1.56; 95% CI, 1.31-1.86). Increased odds for semaglutide initiation were also seen for women who used multiple types of contraception. The highest increased odds for semaglutide initiation were observed in women categorized as having other utilization patterns (aHR = 2.31; 95% CI, 2.06-2.58), those using a combined tablet followed by progestin-only IUD and then progestin-only tablet (aHR = 2.09; 95% CI, 1.8-2.43) and women using a combined tablet plus progestin-only IUD (aHR = 2; 95% CI, 1.79-2.24).

In a BMI-stratified analysis, women with normal weight or underweight had increased odds for starting semaglutide with any hormonal contraception use except for those using a progestin-only tablet. All hormonal contraception use patterns were linked to higher likelihood for starting semaglutide among women with overweight or obesity.

In subgroup analyses, all hormonal conception use regimens raised the likelihood for semaglutide initiation except for progestin-only IUDs in women younger than 30 years. Any hormonal contraception use also increased odds for starting semaglutide across nearly all income and education levels.

Bager said there was a clear link between hormonal contraception and semaglutide initiation in the study, but healthcare professionals should consider a wide range of factors when caring for patients.

“We don’t want to draw an arrow from hormonal contraception directly to semaglutide initiation, and it’s not really the interesting point in this study,” Bager said. “It’s everything that lies between those two. For example, some differences in health-seeking behavior, perceived weight changes, how receptive these women were to pharmacological treatment, lifestyle factors and other metabolic and weight concerns.”