Mounjaro side effects in females: What women should know

In this article:

• How Mounjaro works
• Common side effects of Mounjaro
• Mounjaro side effects in females
• Mounjaro weight loss effects in females
• Mounjaro side effects timeline
• How to avoid Mounjaro side effects
• When to talk to your healthcare provider

In this article

• How Mounjaro works
• Common side effects of Mounjaro
• Mounjaro side effects in females
• Mounjaro weight loss effects in females
• Mounjaro side effects timeline
• How to avoid Mounjaro side effects
• When to talk to your healthcare provider

Mounjaro (tirzepatide) is a prescription drug approved by the Food and Drug Administration (FDA) to treat Type 2 diabetes. However, because it suppresses appetite, Mounjaro is sometimes prescribed off-label for weight loss. As diabetes medications and weight loss medications like Ozempic, Wegovy, and Mounjaro have become more popular, many women have expressed concern about the possibility of female-specific side effects. At this time, there are no studies focused solely on female Mounjaro users, and because these are new medications, the long-term side effects are also unknown. Still, female Mounjaro users need to know that weight loss can impact the menstrual cycle, which affects fertility.

How Mounjaro works

Mounjaro is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. According to Eli Lilly, the drug’s manufacturer, it works by activating the body’s GIP and GLP-1 receptors, stimulating insulin production to improve glucose control and curb cravings. 

For people with Type 2 diabetes, this results in healthier blood sugar levels and, in many cases, a healthier body weight. Mounjaro’s effects on appetite are the reason it is also sometimes prescribed off-label for weight loss. However, tirzepatide, the active ingredient in Mounjaro, is also sold under the brand name Zepbound, which is FDA approved for weight management in adults with obesity or who are overweight with a weight-related health condition. Zepbound is also approved for obstructive sleep apnea.

RELATED: Zepbound vs. Mounjaro

Common side effects of Mounjaro 

In clinical trials, these were the most common side effects of Mounjaro:

• Nausea
• Diarrhea
• Decreased appetite
• Vomiting
• Indigestion
• Stomach pain
• Constipation

Other possible side effects include a fast heartbeat and injection site reactions. Potential serious side effects of Mounjaro include:

• Pancreatitis (inflammation of the pancreas)
• Increased risk of thyroid cancer (thyroid tumors)
• Kidney problems, such as acute kidney injury 
• Changes in vision
• Acute gallbladder problems
• Serious allergic reactions such as anaphylaxis
• Hypoglycemia, or low blood sugar

Anyone taking Mounjaro who starts to experience signs of low blood sugar should immediately be given fast-acting carbohydrates, like juice or candy. Seek urgent medical attention if symptoms continue or blood sugar drops below 55 mg/d. This is a medical emergency.

Mounjaro side effects in females

According to the FDA’s Drug Trial Snapshot, female and male clinical trial participants reported the same Mounjaro side effects at similar rates. However, Supriya Rao, MD, a board-certified gastroenterologist and internist in Massachusetts, says that in her clinical experience, many women report more intense gastrointestinal symptoms. 

“While not widely studied yet, some women on Mounjaro report menstrual changes like lighter periods or fewer cravings, as well as feeling more emotionally steady—likely due to improved blood sugar control,” says Ali McGowan, RD, LDN, a registered dietitian specializing in weight management and women’s health in Providence, Rhode Island. Dr. Rao agrees that anecdotal support links irregular periods to Mounjaro use. However, she says the effect is likely due to rapid weight loss or metabolic shifts, not the medication itself. 

As for potential fertility problems? There hasn’t been enough published research to determine whether tirzepatide increases the chance of infertility, miscarriage, or birth defects, according to MotherToBaby. “No official fertility reg flags yet, but of course, women trying to conceive should follow their doctor’s recommendations—not advice you’ve read on the internet,” Dr. Rao says.

Mounjaro weight loss effects in females

There is some concern that Mounjaro’s appetite suppression may uniquely affect overall health in females. “Because women are more affected than men by inadequate calorie intake, under-fueling may further impact hormones and raise fertility concerns,” McGowan says.

The first concern is hormone health. Dr. Rao says losing fat too quickly can lower estrogen levels — a surefire way to disrupt the menstrual cycle. Hormone imbalance leads to irregular periods, but it can also impact mood and fertility.

Bone density is another concern. McGowan says women in perimenopause or menopause in particular should also be aware that not consuming enough protein, calcium, and vitamin D can negatively impact their bone health. Dr. Rao agrees: “Women tend to lose lean mass pretty quickly on GLP1s. I always recommend strength training to any patients taking these medications (and to all women in midlife, really!).”

“If appetite suppression leads to under-fueling, the risk isn’t just fatigue or mood swings—it’s long-term muscle loss, a slower metabolism, and weaker bones,” McGowan says.

Mounjaro side effects timeline 

Mounjaro is a once-weekly injection. Most side effects develop within days of the first dose. Dr. Rao says many individuals experience nausea, the most common side effect, for a few weeks.

Mounjaro side effects typically lessen as the body adjusts to the medication—usually within four to six weeks, according to Dr. Rao. However, since Mounjaro dosage is increased every four weeks (up to a maximum of 15 mg weekly) until the best dose is found for each patient, the body may need to readjust every time the dose is changed.

How to avoid Mounjaro side effects

It may not be possible to completely avoid Mounjaro side effects, but there are ways to minimize them and help prevent severe side effects. For example:

• Eat smaller, more frequent meals. Eating four small meals per day rather than two or three large ones helps nourish the body without triggering nausea from feeling full.
• Focus on nutrient-dense foods. Mounjaro users feel full very quickly, so it’s important to prioritize foods that are nutrient-dense rather than full of empty calories. McGowan says it’s especially important for women to get enough protein, calcium, vitamin D, and fiber to avoid long-term side effects from nutrient deficiencies. 
• Stay hydrated. Feeling full faster causes some people to drink less water on Mounjaro. Staying hydrated is vital to avoid dehydration, and sipping water throughout the day may also help prevent nausea.
• Request a lower dose. Research shows that tirzepatide side effects are more prevalent at higher doses. Talk to your prescribing healthcare provider about sticking to the lowest effective dose if you are concerned about side effects. 

When to talk to your healthcare provider

It’s normal to experience mild side effects such as gastrointestinal issues after your first dose of Mounjaro. Seek medical advice if you develop debilitating abdominal pain, menstrual cycle irregularities (missed periods, abnormal bleeding, or severe cramping), or signs of nutritional deficiency, such as unexplained tiredness, weakness, or hair loss. 

Mounjaro users should also be aware of the signs of serious side effects that require a trip to the emergency room. These include any intense pain, vision changes, and signs of severe allergic reaction, such as angioedema (swelling of the face or neck) and trouble breathing.

Bottom line

Don’t hesitate to talk to your healthcare provider if you are concerned about any new or worsening side effects from starting Mounjaro. It’s also important to consult your prescriber before starting any new medications, including over-the-counter supplements, while on Mounjaro to avoid harmful or life-threatening drug interactions.