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These elevated estrogen levels trick your body into thinking you are pregnant and therefore prevent ovulation, and could lead to irregular menstrual cycles or even the complete absence of periods. Patients on Zepbound who lose fat may also lose excessive estrogen, potentially helping them return to a more normal cycle

Key considerations include: Pre-existing mental health conditions may be exacerbated during weight loss Physiological changes accompanying weight loss may affect emotional stability Medication effects on gastric emptying may reduce absorption of oral medications, including oral contraceptives (requiring backup contraception after initiation and dose increases) Social and lifestyle changes during treatment create psychological stressors Clinicians should maintain awareness that mood changes during Zepbound therapy likely represent multifactorial phenomena rather than simple cause-and-effect relationships

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Access to alternative medications where clinically appropriate