A new analysis presented at the 2026 Annual Meeting of the Menopause Society found that women using menopause hormone therapy alongside semaglutide lost significantly more weight than those using the drug alone. The same pattern did not hold for tirzepatide.

The drugs involved are semaglutide (sold as Ozempic and Wegovy) and tirzepatide, both widely used GLP-1-based treatments for obesity and type 2 diabetes. Menopause hormone therapy, or MHT, is prescribed for symptoms such as hot flashes, night sweats and vaginal dryness, and the FDA has not approved it for weight loss or obesity management.

What the researchers compared

The study covered 3,855 women with an average age of 57 and an average BMI of 36 kg/m2, split into a semaglutide cohort of 2,379 and a tirzepatide cohort of 1,476. Average follow-up ran 26 months in the semaglutide group and 16 to 17 months in the tirzepatide group.

In the semaglutide cohort, women also using MHT showed significantly greater weight loss at 9 months, and the gap persisted at 12 and 15 months and at final follow-up. They were also more likely to reach up to 30% total body weight loss.

Where the signal fades

The tirzepatide result is the more interesting half of this, precisely because it is the weaker one. Women on MHT showed a modestly greater loss at 3 months and were more likely to exceed 5% total body weight loss by final follow-up, but no significant difference appeared at later time points.

Limitations

The findings have not yet been published in a peer-reviewed journal, and this is an observational comparison, not a randomized trial. Betul Hatipoglu, MD, of University Hospitals Cleveland Medical Center, who was not involved in the work, called the results encouraging but cautioned that they are an association, and said she would not recommend starting hormone therapy solely to improve a GLP-1 weight-loss response on the current evidence.

The study authors said larger studies are needed to confirm the observations. Sherry Ross, MD, an OB-GYN at Providence Saint John's Health Center, said she wants prospective randomized studies of GLP-1 medications with and without hormone therapy.

Bottom line

A drug-specific difference this clean in a cohort this size is worth following, and it raises a mechanistic question nobody has answered. Until a randomized trial runs, it stays an association in women who were taking both drugs for separate reasons.