Understand the source comparison
Peptides for PCOS Treatment Protocol Evidence Guide: Comparison
Semaglutide (Ozempic, Wegovy) GLP-1 receptor agonist. Slows gastric emptying, reduces insulin secretion Meta-analysis: 18–24% reduction in fasting insulin, 31% improvement in ovulation (2024 JCEM) 0.5–1.0mg weekly (PCOS trials); 2.4mg weekly (obesity dose) $90
No winner is assigned.
This page preserves a source comparison for education. It does not add a rating, recommendation or clinical judgment.
- Semaglutide (Ozempic, Wegovy)
- GLP-1 receptor agonist. Slows gastric emptying, reduces insulin secretion
- Meta-analysis: 18–24% reduction in fasting insulin, 31% improvement in ovulation (2024 JCEM)
- 0.5–1.0mg weekly (PCOS trials); 2.4mg weekly (obesity dose)
- $900–$1,200 (brand); $200–$400 (compounded)
- Strongest evidence for metabolic PCOS phenotype with insulin resistance
- Tirzepatide (Mounjaro)
- Dual GIP/GLP-1 agonist. Enhances insulin secretion, improves lipid metabolism
- Observational cohort: 12.4% weight loss, 63% menstrual regularity restoration at 16 weeks
- 5–10mg weekly
- $1,000–$1,300 (brand); $300–$500 (compounded)
- Emerging evidence suggests superior metabolic and reproductive outcomes vs GLP-1 monotherapy
- Liraglutide (Victoza, Saxenda)
- GLP-1 receptor agonist. Daily injection
- RCT: comparable menstrual regularity to metformin, greater weight loss (6.8kg vs 3.1kg at 26 weeks)
- 1.2–1.8mg daily
- $1,100–$1,400
- Effective but daily dosing reduces adherence; cost is prohibitive without insurance
- MK 677 (Ibutamoren)
- Growth hormone secretagogue. Increases GH and IGF-1
- No RCTs in PCOS; one 12-week pilot (n=18) showed modest glucose improvement but high dropout
- 10–25mg daily
- $80–$150
- Lacks PCOS-specific evidence; theoretical risk of worsening insulin resistance
- Metformin (comparator)
- Biguanide. Reduces hepatic glucose output, improves insulin sensitivity
- Cochrane review: improves ovulation in 46% of anovulatory PCOS patients; modest weight loss
- 1500–2000mg daily
- $10–$30
- First-line pharmacologic treatment; GLP-1 peptides outperform for weight loss but not for cost-effectiveness