How GLP-1 Drugs May Lead to Vaginal Changes

• Women are reporting what’s been coined as “Ozempic vulva,” an unexpected side effect of Ozempic and other GLP-1 drugs.
• Ozempic vulva is characterized by sagging skin, vaginal dryness, and weaker pelvic muscles.
• Experts say sagging skin is likely a side effect of rapid weight loss, rather than the weight loss drug itself.
• Pelvic floor physical therapy, vaginal lubricants, and topical estrogen may help with symptom management.

Ozempic and other GLP-1 medications are fast becoming household names for their role in weight loss. Their side effects are making headlines, too.

Alongside well-known side effects like nausea, constipation, and stomach pain, some users are reporting a more unexpected concern: “Ozempic vulva.”

Online, females are sharing changes they’ve noticed since they started taking GLP-1 injections, including sagging skin, vaginal dryness, weaker pelvic muscles, and, in some cases, increased discharge.

“I’ve lost 20 kg or 44 lbs. I’ve been really lucky, and I have no noticeable sagging skin in my tummy or my arms/legs. Then I went to the gyno today cause I was experiencing pain when biking and sitting for long periods,” one woman shared on Reddit.

“Turns out I’ve lost all my fat pads in my vulva! She told me my vulva is saggy and I will continue to experience pain when biking/sitting,” she continued.

While vaginal changes aren’t a listed side effect of GLP-1 medications, experts suggest that rapid weight loss and the loss of fat pads that support vulvar tissue may play a role in these symptoms.

“Ozempic vulva is not a medical term, nor is it a direct side effect of GLP-1 medications,” Prabha Sivaraman, consultant obstetrician-gynecologist at Manchester Deansgate Clinic, United Kingdom, told Healthline.

“What women are noticing is actually the impact of rapid weight loss on soft tissues. The medication itself does not act on the vulva, vagina, or pelvic floor, and the changes are really byproducts of body composition shifting quickly.”

When rapid weight loss occurs, fat pads in the vulva can shrink. This may be particularly noticeable in the mons pubis and labia majora, which provide volume and shape.

“If skin elasticity and connective tissue don’t adapt at the same pace, the result can be a looser or less supported appearance,” Sivaraman explained.

“It’s essentially the same mechanism we see elsewhere in the body. When weight drops rapidly, the skin and tissues sometimes lag behind.”

Daniel Atkinson, a general practitioner and clinical lead at Treated, United Kingdom, told Healthine that it’s important to remember weight loss looks different on everyone.

“People have little control about which parts of their body are affected,” he pointed out.

“The vulva contains fatty tissue, so its appearance and elasticity could potentially change when someone loses weight, in the same way certain other areas of the body might look and feel different.”

Sagging skin isn’t the only reported side effect of GLP-1 medications. Some women also report experiencing vaginal dryness and muscle weakness.

Sivaraman said neither dryness nor pelvic muscle weakness is caused by GLP-1 medication itself.

“Vaginal dryness is almost always hormonal and could be due to menopause or contraceptives,” she explained.

Muscle weakness, including in the pelvic floor, can occur if weight loss is accompanied by loss of lean muscle mass.

“Without resistance training and adequate nutrition, some muscle strength is inevitably lost. These are consequences of rapid weight and body composition changes, not of the drug directly,” Sivaraman said.

If you’re experiencing any of these side effects, when are they a cause for concern?

Atkinson said it’s a good idea to start with a visual check.

“It’s worth considering these changes might occur for other reasons too, such as hormonal changes, other medications, or even genetics,” he shared.

“However, if you experience vaginal irritation and discomfort you think is happening because of your treatment, you should speak to your prescriber right away.”

Cosmetic differences like sagging skin aside, Sivaraman said there are other changes to be mindful of.

“Concern arises if new symptoms develop, such as urinary leakage, pelvic heaviness, bulging, or painful dryness.

“Those symptoms may point to pelvic floor issues or hormonal changes, and they are worth seeking medical advice about because effective treatments are available,” she explained.

If you’ve experienced rapid weight loss and are navigating vaginal changes, some treatment options are available.

“Surgery is not the first line of management and should be considered only if symptoms are severe or persistent,” Sivaraman advised.

There are many supportive measures, many of which you can try at home.

Adjusting your approach to weight loss may prove useful, too. “Maintaining gradual, well-paced weight loss and incorporating resistance training protects tissues and muscle tone,” Sivaraman noted.

If your discomfort persists, your clinician can offer advice on how to manage it and help you determine if your weight loss treatment is the cause.

Sivaraman said these changes are not unique to GLP-1 medications like Ozempic.

“Any method of significant weight loss, whether through bariatric surgery, strict dieting, or medication, can cause them,” she explained.

“What makes the difference is the speed and scale of weight loss. Rapid, large reductions make changes more noticeable, while gradual weight loss gives tissues more opportunity to adapt.”