Hannah Brown’s GLP-1 Prescription for PCOS Puts a Spotlight on Off-Label Use

Hannah Brown recently opened up on the SHE MD podcast about something she had kept private for years. She talked about her long battle with Polycystic Ovary Syndrome, better known as PCOS. But beyond the personal story, what she shared raised some important questions about how doctors are treating this condition today.

Brown said she struggled with irregular periods, cystic acne, weight changes, and anxiety for over a decade. Doctors kept dismissing her concerns. Then a GLP-1 medication, combined with metformin, finally gave her regular 28 to 30-day cycles. For many women in the same situation, hearing that is a big deal.

So what exactly is PCOS? It affects roughly 6 to 10 percent of women of reproductive age in the United States. At its core, it is a metabolic problem, not just a hormonal one. When insulin resistance levels stay too high for too long, they throw off the body’s hormone balance. That leads to irregular ovulation, inflammation, weight gain, and other symptoms that can feel impossible to manage.

That insulin connection is exactly why GLP-1 drugs have started showing up in PCOS treatment. Medications like semaglutide and tirzepatide, found in brands like Wegovy, Ozempic, and Mounjaro, help the body produce insulin more efficiently. They also lower glucagon levels. Together, these effects reduce the hormonal chaos that PCOS creates. Doctors often add metformin to the mix to go after the root problem even more directly.

And this approach is clearly catching on. Data from Truveta, a health research company, shows that GLP-1 prescriptions among women with PCOS jumped from 2.4 percent in 2021 to 17.6 percent in 2025. That is a massive increase in just four years. The striking part is that none of this growth came from an official FDA approval for PCOS treatment.

That is where things get complicated. The FDA has not approved any GLP-1 drug specifically for PCOS. So when doctors prescribe them for this condition, it counts as off-label use. Most insurers will only cover these medications if the patient also has obesity or type 2 diabetes. Women who have PCOS but do not meet those criteria often get denied, even when their doctor thinks the medication is the right call.

Cost and price are other real barriers. Without insurance, the price of GLP-1 medications can run several hundred dollars every month. That puts them out of reach for a lot of patients who could genuinely benefit. For women who do not qualify under approved indications, the out-of-pocket cost becomes the only option, and it is one that most cannot sustain long term.

Still, the medical evidence keeps building. Studies show that when insulin sensitivity improves, women with PCOS often see more regular periods, lower androgen levels, and better overall metabolic health. In fact, updated PCOS treatment guidelines from 2023 already recommend semaglutide as an option, specifically because it targets insulin problems at the source. The FDA has not started a formal review for a PCOS indication yet, but the science is clearly moving in that direction.

Brown also revealed something else during her diagnostic journey. Doctors found she has a septate uterus, a condition where a strip of tissue splits the uterine cavity in two. This raises the risk of miscarriage and can make getting pregnant harder. She confirmed she is working with her medical team on a plan that includes a surgical option before she and her partner try to conceive.

By speaking openly about all of this, Brown is joining a larger conversation that many women have been trying to start for years. PCOS has often been brushed off or misunderstood, even by medical professionals. Too often, it gets treated as a cosmetic issue rather than the serious endocrine disorder it actually is.

What her story really highlights is a gap in the system. Doctors are using off-label prescribing to fill a space that official medical guidance has not caught up with yet. As more clinical research comes in, the pressure on the FDA, insurance companies, and medical organizations to act will keep growing. Women with PCOS should not have to rely on workarounds and secondary diagnoses just to access treatment that addresses what is actually wrong.