Wegovy (semaglutide 2.4 mg) is a GLP-1 receptor agonist licensed in the UK for weight management in adults with obesity or overweight with comorbidities. Does Wegovy cause hot flushes? Hot flushes are not listed as a recognised side effect in official UK prescribing information, though some patients report experiencing them. Understanding the relationship between Wegovy, weight loss, and vasomotor symptoms helps distinguish medication effects from physiological changes during treatment. This article examines the evidence, explores alternative explanations, and provides guidance on managing symptoms and when to seek medical advice.

What Is Wegovy and How Does It Work?

Wegovy is the brand name for semaglutide 2.4 mg, a prescription medicine licensed in the UK for weight management in adults with obesity or those who are overweight with weight-related health conditions. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which were originally developed for treating type 2 diabetes but have demonstrated significant efficacy in promoting weight loss.

The medication works by mimicking the action of GLP-1, a naturally occurring hormone in the body that regulates appetite and food intake. Semaglutide binds to GLP-1 receptors in the brain, particularly in areas that control appetite and satiety. This action leads to reduced hunger, increased feelings of fullness after eating, and consequently a reduction in calorie intake. Additionally, semaglutide slows gastric emptying, meaning food remains in the stomach for longer, which contributes to prolonged satiety between meals.

Wegovy is administered as a once-weekly subcutaneous injection, typically in the abdomen, thigh, or upper arm. Treatment begins with a low dose that is gradually increased over several weeks to minimise gastrointestinal side effects and allow the body to adjust to the medication. In the UK, NICE guidance (TA875) recommends Wegovy for adults with a BMI of at least 35 kg/m² (or 30 kg/m² with weight-related comorbidities), with lower thresholds for some ethnic groups. Treatment should be provided within specialist weight management services and is limited to a maximum duration of 2 years.

Clinical trials have demonstrated that Wegovy can help patients achieve substantial weight loss when combined with lifestyle interventions. However, like all medications, it may cause side effects, and patients should be fully informed about potential adverse reactions before commencing treatment. Importantly, Wegovy is contraindicated during pregnancy and is not recommended during breastfeeding. Understanding how Wegovy works helps contextualise any symptoms that may arise during therapy.

Does Wegovy Cause Hot Flushes?

Hot flushes are not listed as a common or recognised side effect of Wegovy in the official Summary of Product Characteristics (SmPC) approved by the MHRA or in the patient information leaflet. The most frequently reported adverse effects of semaglutide include gastrointestinal symptoms such as nausea, vomiting, diarrhoea, constipation, and abdominal pain. These occur because GLP-1 receptor agonists affect the digestive system directly as part of their mechanism of action.

There is no established pharmacological mechanism by which semaglutide would directly cause hot flushes or vasomotor symptoms, although it should be noted that GLP-1 receptor agonists can increase heart rate and rarely cause hypersensitivity reactions which may include flushing. The medication primarily targets metabolic and appetite-regulating pathways rather than the hormonal pathways typically associated with hot flushes, such as oestrogen or testosterone regulation, or the neurotransmitter systems involved in thermoregulation.

However, some patients taking Wegovy have anecdotally reported experiencing sensations of warmth, flushing, or hot flushes. It is important to recognise that correlation does not necessarily indicate causation. When patients begin weight loss treatment, multiple physiological changes occur simultaneously, and symptoms may arise from the weight loss process itself, dietary changes, increased physical activity, or coincidental factors rather than the medication directly.

If you experience hot flushes whilst taking Wegovy, it is worth considering other potential causes. These symptoms could be related to hormonal changes associated with weight loss, perimenopause or menopause in women, anxiety, dietary modifications, or other concurrent health conditions. A thorough assessment by your GP or prescribing clinician can help determine the underlying cause and whether the symptoms are genuinely related to your medication or require investigation for alternative explanations.

Why Might Hot Flushes Occur During Weight Loss Treatment?

Significant weight loss, regardless of the method used to achieve it, can trigger various physiological changes that may potentially manifest as hot flushes or similar vasomotor symptoms. Adipose tissue is not merely a storage depot for energy; it is an active endocrine organ that produces and metabolises hormones, particularly sex hormones such as oestrogen. When substantial fat loss occurs, the reduction in adipose tissue may alter circulating hormone levels, which could theoretically lead to symptoms similar to those experienced during hormonal transitions.

In women, weight loss may affect oestrogen metabolism and could potentially unmask or coincide with perimenopausal symptoms, including hot flushes. Women who are approaching or in the early stages of menopause may find that weight loss coincides with the natural hormonal fluctuations of this life stage, making it difficult to distinguish whether symptoms are medication-related, weight-loss-related, or simply part of the menopausal transition. The NHS and NICE (NG23) provide comprehensive guidance on diagnosing and managing menopausal symptoms, which may be relevant for women experiencing hot flushes during weight loss treatment.

Other factors that might contribute to sensations of warmth or flushing during weight loss treatment include hypoglycaemia (particularly in people taking insulin or sulfonylureas alongside Wegovy), dehydration resulting from gastrointestinal side effects, and changes in metabolic rate as body composition changes. Increased physical activity, which is typically recommended alongside Wegovy treatment, can also lead to more frequent episodes of feeling warm or flushed, particularly during and after exercise.

Dietary modifications often implemented during weight loss programmes may play a role as well. Some patients report that specific dietary changes, such as reducing carbohydrate intake or adopting intermittent fasting patterns, can be associated with sensations of warmth or temperature fluctuations. Understanding these multifactorial influences helps contextualise symptoms and guides appropriate management strategies.

Managing Hot Flushes While Taking Wegovy

If you experience hot flushes whilst taking Wegovy, several practical strategies may help manage these symptoms effectively. Keeping a symptom diary can be valuable in identifying potential triggers and patterns. Record when hot flushes occur, their severity, duration, and any associated activities, foods, or circumstances. This information can help you and your healthcare provider determine whether the symptoms are related to medication, lifestyle factors, or other causes.

Lifestyle modifications can significantly reduce the frequency and severity of hot flushes. Wearing layered clothing allows you to adjust quickly to temperature changes. Choose natural, breathable fabrics such as cotton or moisture-wicking materials that help regulate body temperature. Keeping your environment cool, using fans, and ensuring good ventilation in your home and workplace can provide relief. Many people find that keeping a cold drink nearby and using a handheld fan during episodes helps manage acute symptoms.

Dietary considerations may also prove beneficial. Some individuals find that avoiding known triggers such as caffeine, alcohol, spicy foods, and hot beverages reduces the frequency of hot flushes. Staying well-hydrated throughout the day supports overall thermoregulation. Maintaining regular meal times and avoiding prolonged periods without eating may help stabilise metabolic processes that could influence temperature regulation.

Stress management techniques, including mindfulness, deep breathing exercises, and regular physical activity, can help reduce the frequency and intensity of hot flushes. Stress and anxiety can exacerbate vasomotor symptoms, so incorporating relaxation practices into your daily routine may provide meaningful benefit. If hot flushes are significantly affecting your quality of life or sleep, discuss this with your GP. They may recommend additional investigations to rule out other causes or suggest specific treatments if symptoms are determined to be related to hormonal changes (such as menopause) rather than the medication itself. Do not discontinue Wegovy without consulting your prescribing clinician, as abrupt cessation may affect your weight management progress.

If you suspect your symptoms might be a side effect of Wegovy, you can report this through the MHRA Yellow Card scheme, which helps monitor the safety of medicines in the UK.

When to Seek Medical Advice About Side Effects

Whilst hot flushes alone are generally not a medical emergency, certain circumstances warrant prompt medical attention. If you experience hot flushes accompanied by chest pain, severe headache, difficulty breathing, rapid or irregular heartbeat, dizziness, or fainting, seek immediate medical assessment. These symptoms could indicate a more serious condition requiring urgent evaluation, such as cardiovascular issues or severe allergic reactions.

You should contact your GP or prescribing clinician if hot flushes are severe, persistent, or significantly impacting your daily activities and quality of life. If symptoms interfere with sleep to the extent that you feel chronically fatigued or unable to function normally, medical review is appropriate. Your healthcare provider can assess whether these symptoms require investigation for underlying causes such as thyroid dysfunction, hormonal imbalances, or other medical conditions that may coincidentally have emerged during your treatment period.

It is particularly important to seek medical advice if you develop new or worsening symptoms whilst taking Wegovy. Recognised side effects that require medical attention include severe abdominal pain (which could indicate pancreatitis), persistent nausea and vomiting leading to dehydration, signs of gallbladder problems such as jaundice or right upper abdominal pain, changes in vision (especially if you have type 2 diabetes with pre-existing diabetic retinopathy), or symptoms of hypoglycaemia if you are taking other diabetes medications. Any allergic reactions, including rash, itching, swelling, or difficulty breathing, require immediate medical assessment.

Wegovy is contraindicated during pregnancy and not recommended during breastfeeding. If you are of childbearing potential, you should use effective contraception while taking Wegovy. If you become pregnant or wish to become pregnant, you should stop Wegovy at least 2 months before planned conception and contact your healthcare provider immediately for advice.

Regular follow-up appointments with your prescribing clinician are an essential component of safe Wegovy treatment. These consultations allow monitoring of your weight loss progress, assessment of side effects, and adjustment of treatment as needed. Be open and honest about all symptoms you experience, even if they seem unrelated to the medication. Your healthcare provider can only provide appropriate care and guidance when fully informed about your experience. Remember that effective weight management requires a collaborative approach between you and your healthcare team, and reporting concerns promptly ensures you receive optimal support throughout your treatment journey. Any suspected side effects can also be reported via the MHRA Yellow Card scheme.

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