Jessica Yih, MD, on vulvar tissue changes among women receiving GLP-1RAs

In the following video, Jessica M. Yih, MD, highlights the background and key findings from a study on vulvar tissue changes among non-diabetic women receiving glucagon-like peptide-1 receptor agonists (GLP-1RAs) for weight loss.¹ These results were presented at the 2026 Annual Meeting of the International Society for the Study of Women's Sexual Health (ISSWSH) in Long Beach, California.

Yih is a urologist at the University of California, Irvine.

Yih explained that as use of these agents has expanded, some patients have reported changes in vulvar appearance, an issue that has gained traction in both clinician conversations and mainstream media coverage. This prompted interest in assessing whether GLP-1 RAs may have unintended effects on vulvovaginal health.

To explore this question, Yih and colleagues conducted a propensity score–matched analysis using the TriNetX database to compare rates of vulvar hypertrophy and vulvar atrophy diagnoses among patients taking GLP-1RAs (n = 617,407) vs those not receiving these medications (n = 84,711,992). Because colloquial terms such as “Ozempic vulva” do not correspond to formal medical diagnoses, the investigators selected these billing-associated diagnostic codes as clinical proxies for patients presenting with excess labial tissue or vulvar tissue loss, respectively.

Overall, vulvar atrophy or hypertrophy was diagnosed in 375 patients on GLP-1RAs (0.061%) and 51,157 non-users (0.060%). Following demographic and comorbidity matching, there was no statistically significant difference in the diagnoses of vulvar hypertrophy or vulvar atrophy among patients receiving GLP-1 RAs compared with matched controls (absolute risk difference, 0.001%; 95% CI –0.02 to 0.02; two-tailed P = 0.97).

Yih emphasized, however, inherent limitations of large database studies, which include variability in screening practices, underdiagnosis of sexual health concerns, and barriers to specialty evaluation. She explained that these may obscure clinically relevant symptoms that are not formally documented. As such, while these findings may help contextualize anecdotal reports, they also underscore the need for prospective investigation and improved screening for vulvovaginal symptoms in patients undergoing medical weight loss.

REFERENCE

1. Hammad MA, Nakamura HS, Yih J. Vulvar Tissue changes in non-diabetic women receiving GLP-1 receptor agonists: A global federated cohort analysis. Presented at: International Society for the Study of Women's Sexual Health Annual Meeting 2026. February 12-15, 2026. Long Beach, California. Abstract 010