Mounjaro and Pregnancy

Medically Reviewed by Jabeen Begum, MD on July 21, 2024
7 min read

Mounjaro (tirzepatide) is a powerful tool when it comes to managing type 2 diabetes and losing weight. But it’s not advised to take this medication if you’re pregnant, trying to have a baby, or breastfeeding. We need more research that proves that it won’t harm your baby.

When you’re expecting a baby, you want to stay as healthy as possible. It’s important to get enough nutrients so your baby develops the way they’re supposed to.

Common side effects of Mounjaro could make that a challenge. Some people who take it report symptoms like: 

  • Upset stomach
  • Stomach pain
  • Diarrhea
  • Constipation
  • Indigestion (heartburn)
  • Loss of appetite

It’s also unclear if this type of weight loss drug can cause depression or thoughts of suicide. 

So far, there’s very limited data about how Mounjaro could affect you or your baby during a pregnancy. The first large study to be done found that GLP-1 receptor agonists don’t cause birth defects any more than taking insulin does. But the researchers noted that some of their results were imprecise. We need much more research to know for sure.  

For now, the FDA does not recommend taking Mounjaro while you’re pregnant. 

Rarely, a doctor could suggest that you take it while you’re expecting a baby. If so, it’s because they think the benefit to your health will outweigh the risks. 

For instance, when diabetes isn’t managed well during pregnancy, it can raise your risk of serious issues like:

  • Diabetic ketoacidosis (DKA)
  • Preeclampsia
  • Miscarriage
  • Preterm delivery
  • Major birth defects
  • Stillbirth

There’s also limited data about how safe Mounjaro is to take while you’re nursing. For instance, doctors still don't know:

  • If Mounjaro could interfere with the amount of breast milk your body makes
  • How much of the drug could get into your breastmilk
  • How Mounjaro in your breast milk could affect your baby

Until these questions can be safely answered, doctors strongly advise not taking Mounjaro while you’re breastfeeding.

Research shows that being overweight can make it harder to get pregnant. Carrying extra pounds can throw your body’s hormones out of balance. That can then cause issues with your menstrual cycle (period) and ovulation (when a mature egg is released from your ovaries). 

So far, there’s no proof that Mounjaro could harm your fertility. Just the opposite may be true. Getting to a healthy weight can improve your blood sugar levels, reduce insulin resistance, and help level out your hormones. Studies have shown that all these things can make it easier for you to conceive.

Still, doctors recommend waiting at least 2 months between when you stop taking Mounjaro and when you start trying to get pregnant. That way, you can be sure the drug is out of your body.

If your doctor believes you still need to be on medication to control your blood sugar, they can prescribe a different type of drug. For instance, metformin, a diabetes treatment that’s been around since the 1990s, is known to be safe to take during pregnancy. 

In whatever course of action you and your doctor decide, you’ll likely see the best results if you also try to start and maintain healthy habits. Taking care of yourself will also help you have a healthy pregnancy. For instance, you can:

  • Try to find a physical activity you enjoy so you’re more likely to do it
  • Opt for more whole foods (like fruits, vegetables, whole grains, and lean proteins) 
  • Stop using unhealthy substances like tobacco, marijuana, illegal drugs, and alcohol if you currently use them. 

You might have heard or read about “Mounjaro pregnancy” or "Ozempic babies.” That’s the trend of some people getting pregnant while taking GLP-1 receptor antagonists like Ozempic or Mounjaro, even if they’re taking oral birth control. This can also happen with the drugs Wegovy and Zepbound.

There are a few reasons these unplanned pregnancies can happen. If you’re not taking birth control, it’s probably because of the weight the drug helped you lose. When you’re carrying extra weight, it’s common to stop ovulating. Drugs like Mounjaro can help you lose enough weight that your menstrual cycle returns to normal and you start ovulating again.  

It’s also possible to get pregnant while taking a GLP-1 receptor antagonist even if you are taking a birth control pill. That’s because when you take a drug like Mounjaro, your digestive system moves more slowly than normal. Your stomach takes longer to empty. That limits how much of a birth control pill gets absorbed into your system.

Ozempic and Wegovy (semaglutide) don’t carry a label warning about specific interactions with birth control. It’s only noted that they could make any pill you take by mouth less effective. 

Mounjaro and Zepbound (tirzepatide) specifically warn that when you take either of these drugs, your birth control pill won’t give you as much protection. 

Some studies also suggest that weight loss drugs like Ozempic can improve sperm health, for instance, the number of sperm you produce, how fast or mobile they are, and how many are in good enough shape to penetrate an egg. This can cause “surprise” pregnancies too.

Should I change how I take birth control with Mounjaro?

If you take a birth control pill by mouth, it’s a good idea to switch to another type that doesn’t need to go through your GI tract. For instance, you could ask your doctor about one of these methods:

Vaginal ring (birth control ring): A small, flexible ring you insert into your vagina for 3 weeks at a time. It releases hormones that stop your ovaries from releasing an egg and makes it harder for sperm to reach an egg.

Intrauterine device (IUD): A tiny device your doctor places in your uterus. It triggers a reaction in your immune system that stops sperm from fertilizing an egg.

Contraceptive (arm) implant: A device about the size of a matchstick that your doctor puts just under the skin of your upper arm. It releases hormones that stop you from releasing an egg and also make it harder for a fertilized egg to implant.

Another option is to keep taking your birth control pill as prescribed, but also use a back-up form of birth control, such as a condom. Right now, the makers of Mounjaro suggest that you use extra protection for:

  • 2 months after you start Mounjaro
  • 2 months after your Mounjaro dosage goes up

These guidelines may change over time, as researchers complete more studies on Mounjaro. Talk to your doctor if you have any questions.

Studies show that Mounjaro can be an important tool in managing type 2 diabetes and helping you get to a healthy weight. But there’s not enough data yet to know if it’s safe to take during pregnancy or while you’re breastfeeding. If you take Mounjaro, talk to your doctor about your birth control options and when you should stop the drug if you want to get pregnant.

What if you get pregnant on Mounjaro?

Tell your doctor right away. They can walk you through the risks of a pregnancy. They can also explain the different tests that are available to get more information on the status of your pregnancy and help you figure out your next steps.

What happens if you get pregnant on semaglutide?

Semaglutide is the generic name for Ozempic. Like Mounjaro, it’s approved by the FDA to treat diabetes. But it can be prescribed “off-label” for weight loss. The drug Wegovy is also semaglutide, but it’s a higher dose. Wegovy is approved by the FDA as an obesity medication.  

Like Mounjaro, there’s very limited data about how semaglutide could affect your pregnancy. Doctors don’t yet know if it could raise the chances of preterm birth (having your baby before the due date) or increase the risk that your baby will be born with birth defects or a low birth weight (under 5 pounds, 8 ounces). 

There’s also no way of knowing yet if taking semaglutide while you’re pregnant could affect your child’s behavior or learning ability.

Early results from animal studies show that semaglutide could increase the risk of miscarriage, but it’s not clear if that’s because of weight loss, medication, or other factors. Researchers need to do more study to understand this question completely. 

If you find out that you are pregnant while you’re taking semaglutide, the steps you’ll take are the same as if you get pregnant on Mounjaro: Let your doctor know right away. They can assess your health and talk through the risks you may face during a pregnancy.

Can you take weight loss medication while trying to get pregnant?

If you have a BMI of 30 or above and are thinking about having a baby, talk to your doctor. Together, you can figure out the safest way for you to take care of your health while starting or adding to a family.

Can you take weight loss injections while pregnant?

Generally speaking, experts don’t recommend that you lose weight while you’re pregnant. You should expect to gain weight, especially in the second and third trimester, as your baby grows. 

If your doctor has recommended that you lose weight, the best time to do it is before you try to get pregnant. Even losing 5% of your body weight can reduce the risk of:

  • Miscarriage
  • Stillbirth
  • Birth defects
  • A baby that’s much larger or smaller than average
  • Blood clots
  • Endometriosis
  • Gestational diabetes