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Direct-pay telehealth, 48 states + DC.
Program · PCOS
Clinician-guided evaluation for women with PCOS, focused on insulin resistance and weight. Dosing individualized by licensed clinicians. Telehealth in 48 US states + DC (AK and MS not served).
$0 today — you are only charged if a licensed clinician prescribes.
How it works
Finish the 5-minute intake
Answer the health questions online — no appointment needed to start.
A licensed clinician reviews your visit
Every intake is reviewed individually. If the PCOS protocol is not appropriate for you, the clinician says so.
If prescribed, it ships in 3–5 days
Your prescription ships from a US-licensed pharmacy. Follow-ups happen online.
Plans start at $149/month ($134/month billed annually) for the Microdose GLP-1 protocol; your exact price is shown during intake, before any payment. $0 today — you are only charged if a licensed clinician prescribes.
PCOS affects roughly one in ten women of reproductive age. The cycle irregularity, androgen excess, hirsutism, and weight that come with it all trace back to the same metabolic axis: hyperinsulinemia drives the ovary to overproduce androgens. Improving insulin sensitivity and reducing body weight are the two interventions with the most consistent evidence in PCOS — and GLP-1 receptor agonists are under active study for both, now recognized by the 2023 international PCOS guideline as an option for weight management.
What researchers have reported
In studies: free testosterone
Published PCOS trials of GLP-1 medications report improvements in insulin sensitivity, with androgen markers such as free testosterone tending to follow. Trials are small and heterogeneous, findings come from studies of non-compounded medications, and individual results vary.
In studies: body weight
A 4,241-woman UK real-world tirzepatide cohort (2025) reported 18.8% median weight loss at ten months in women with PCOS — with 91% reaching ≥10% loss. The cohort studied non-compounded tirzepatide; individual results vary and are not guaranteed.
In studies: cycle regularity
Pooled PCOS trial data show ~68% improvement in menstrual regularity and ~55% increase in ovulation rates — largest among patients losing ≥10% body weight. Findings from studies of non-compounded GLP-1 medications; individual results vary and no cycle outcome is guaranteed.
Mechanism
The Rotterdam criteria define PCOS clinically by some combination of irregular cycles, biochemical or clinical hyperandrogenism, and polycystic ovarian morphology. But underneath the diagnostic criteria, the dominant mechanism in the majority of cases is insulin resistance. Insulin and related growth-factor signaling affect ovarian theca cells; chronically elevated insulin pushes androgen synthesis up and suppresses sex-hormone binding globulin, which raises free testosterone and amplifies the phenotype.
In published studies, GLP-1 receptor agonists have been associated with two relevant effects: improved insulin sensitivity and clinically meaningful weight loss — the same metabolic pattern seen in most PCOS cases. That overlap is why researchers have studied GLP-1s for the insulin-resistance and weight components of PCOS. Individual response varies.
Clinical evidence
The clearest evidence base in PCOS is for liraglutide — multiple RCTs since 2014 have shown weight loss, improved insulin resistance, and improved menstrual regularity. Semaglutide and tirzepatide are newer in this indication but the evidence has compounded fast since 2022: small RCTs and real-world cohorts consistently report 10–15% weight loss at six months, large drops in HOMA-IR, reductions in free androgen index, and meaningful improvements in cycle regularity.
The 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome — the global standard-of-care document co-published by ESHRE, the Endocrine Society, the ASRM, and the Monash Centre for Health Research — formally recognizes GLP-1 receptor agonists as an option for weight management in women with PCOS who have not responded to lifestyle intervention. That guideline shifted GLP-1 from off-protocol to inside the international standard for PCOS care.
Who it's for
Fertility timing — read this carefully
GLP-1 receptor agonists are not used during conception, pregnancy, or breastfeeding. If you are planning to conceive, current labeling guidance is to discontinue semaglutide at least two months before a planned pregnancy; tirzepatide guidance is similar. If TTC is on your near-term horizon, tell your clinician during intake — the protocol gets planned around your fertility window, not the other way around. Some women and their clinicians plan GLP-1 therapy ahead of a conception timeline, then wash out before TTC. Whether and how that sequencing fits your situation is a decision for your clinician during intake.
Related programs & reading
Drug · GLP-1
Semaglutide is the GLP-1 most studied in PCOS research (studies used non-compounded semaglutide). Weekly subcutaneous; dosing determined by a licensed clinician.
Drug · GLP-1/GIP
Dual-receptor (GLP-1/GIP) option. A licensed clinician can discuss whether it fits your goals and clinical picture.
Sibling hub
Lower-dose option a licensed clinician may consider when significant weight loss is not the primary goal.
Read · Pillar
The pillar article — trial summaries, effect sizes, and the 2023 guideline change.
FAQ
PCOS is, at its metabolic core, an insulin-resistance condition. Hyperinsulinemia drives ovarian theca cells to overproduce androgens, which in turn drive the cycle irregularity, hirsutism, acne, and weight retention many women with PCOS experience. In published studies, GLP-1 receptor agonists have been associated with improved insulin sensitivity, lower fasting insulin, and weight loss — the same metabolic pathways involved in PCOS. Research also suggests that losing 5–10% of body weight is associated with the return of ovulation in some women with PCOS. Individual results vary; a licensed clinician determines whether therapy is appropriate.
Randomized and observational trials of semaglutide and tirzepatide in women with PCOS have reported significant improvements in body weight, HOMA-IR (a marker of insulin resistance), free androgen index, and menstrual regularity. The 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome — the global standard-of-care document — formally recognizes GLP-1 RAs as a treatment option for weight management in women with PCOS who have not responded sufficiently to lifestyle intervention. Individual response varies, and effect sizes depend on baseline weight, duration of therapy, and adherence.
No medication can guarantee that. What studies have reported is that weight loss and improved insulin sensitivity observed during GLP-1 therapy are associated with more regular cycles and higher ovulation rates in many women with PCOS — findings from studies of non-compounded medications, not a guarantee for any individual. The clinician will not promise a specific cycle outcome. If cycle restoration is a primary goal, your clinician may also discuss other options (lifestyle, inositol, metformin) and how they layer with GLP-1.
No. GLP-1 receptor agonists are not appropriate during conception, pregnancy, or breastfeeding. Patients planning to conceive must wash out the medication before trying — current labeling guidance is to discontinue semaglutide at least two months before a planned pregnancy, and the washout for tirzepatide is comparable. This is one of the most important conversations to have during intake — if your timeline includes TTC, the clinician will plan the protocol around your fertility window, not the other way around.
Operationally it uses the same medications (compounded semaglutide or tirzepatide), but the clinical reasoning is different. The clinician pays closer attention to insulin-resistance markers (HOMA-IR, fasting insulin, A1c), androgen markers (free testosterone, DHEA-S, SHBG), and cycle history. Dose decisions weigh these alongside scale weight. Many women with PCOS do well at lower doses than the trial-curve target dose — microdose protocols are explicitly an option here when significant weight loss is not needed.
Metformin and myo-inositol both improve insulin sensitivity through different mechanisms and are widely used in PCOS care. They are not exclusive with GLP-1 — many patients stack them. Your clinician will review what you are already taking and what makes sense to add, continue, or change. The decision is made individually; the clinician will not push or remove an existing medication without medical reason.
The side-effect profile is the same as for the general weight-loss population: nausea, reduced appetite, occasional gastrointestinal disruption, and rare but serious risks (pancreatitis, gallbladder issues, certain thyroid contraindications). PCOS patients with a history of gastroparesis, prior bariatric surgery, or significant gallbladder disease should disclose that during intake — these are common comorbidities and they change the dose plan.
Plans start at $149/month ($134/month on an annual plan) for the Microdose GLP-1 protocol. Pricing depends on the medication and the dose the clinician determines is appropriate for you — a lower-dose protocol and a higher-dose protocol are not priced the same. Your exact monthly price is shown during intake, before any payment, and nothing is charged until a clinician prescribes.
The protocol is delivered via telehealth in 48 US states and the District of Columbia (Alaska and Mississippi are not currently served). Initial intake, clinician review, prescription, and follow-up visits are all conducted online. Bloodwork is not a standard part of the program and most patients will not need it — in the unlikely case the clinician determines lab work is necessary, an at-home lab test can be arranged for an additional charge, with the cost shown before anything is ordered. In-person care is not required to enroll, but the clinician may recommend an in-person GYN or endocrinology visit alongside the program if the clinical picture warrants it.
Compounded preparations are NOT FDA-approved drugs, are NOT generic versions of branded medications, and are not represented as therapeutically equivalent to any FDA-approved product. They are prepared by licensed 503A or 503B compounding pharmacies under specific federal rules. Whether a compounded preparation is clinically appropriate for a given patient is an individualized clinical decision made by the prescribing clinician. TelePeptide does not sell, distribute, or supply branded medications.
Next Step
A licensed clinician will review your goals and recommend the right protocol — peptide wellness, recomposition, or supervised weight loss. No insurance, no waiting room.
Compounded medications are prepared by licensed 503A pharmacies. Prescribing decisions are made solely by licensed clinicians based on individual medical necessity. These statements have not been evaluated by the FDA. Compounded medications are not FDA-approved. GLP-1 use for PCOS is off-label. Individual results vary — no weight-loss or treatment outcome is guaranteed. Completing an intake does not guarantee a prescription; licensed clinicians independently determine whether treatment is medically appropriate. GLP-1 use for PCOS is supported by the 2023 International Evidence-Based Guideline for PCOS as an option for weight management in women who have not responded to lifestyle intervention. GLP-1 medications are not used during pregnancy or breastfeeding. Patients planning to conceive must wash out the medication per current labeling before TTC.