Ozempic vulva: what it is, symptoms, and tips for treatment and overall pelvic health

GLP-1 medications like Ozempic are helping many people achieve rapid weight loss and better blood sugar control. But along with these effects, some people are noticing other unexpected body changes, such as those in the genital area. This is becoming known as  “Ozempic vulva.”

“‘Ozempic vulva’ is not an official medical diagnosis,” says Bijal Toprani, PT, DPT, a physical therapist at Hinge Health. It’s a term used to describe a range of physical changes to the vulva, like sagging skin or loss of volume, that can happen with rapid weight loss, whether from medication like Ozempic or another cause, she explains. While the name focuses on the external genital area, it can also refer to changes in pelvic health, such as vaginal dryness or other symptoms. “These changes are mainly cosmetic, but they can feel surprising or upsetting, especially when you’re otherwise happy with the effects of the medication.”

Not everyone who uses GLP-1 medications will experience changes like Ozempic vulva, and you may not be able to prevent them entirely. If you do notice changes, there are steps you can take to support your body as it adjusts to weight loss and other changes. Losing weight at a steady pace, staying active, getting adequate protein, and prioritizing muscle and pelvic floor strength may help.

Here, learn more about Ozempic vulva, including its causes, symptoms, and treatments. Plus, get exercises and tips from Hinge Health physical therapists.

What is Ozempic vulva?

“Ozempic vulva” is an informal way to describe changes to the external female genitalia that can happen after significant weight loss on GLP-1 medications like Ozempic, Wegovy, Mounjaro, or others. This class of drugs, originally used for type 2 diabetes, is now widely used for weight loss because the medications curb appetite, slow digestion, and promote weight loss. 

While losing weight can have many health benefits, it often leads to changes in body composition, including reductions in both fat and muscle mass. When weight comes off quickly, certain areas naturally affected by fatty tissue can show visible changes, including the face, buttocks, and other areas, such as the vulva.

The vulva is the term for the external part of the female genital area. It includes the outer and inner lips (labia majora and labia minora), the clitoris, and the area surrounding the vaginal and urethral openings. The vulva is different from the vagina: the vagina is the internal passageway that connects the outside of the body to the uterus, while the vulva is everything on the outside.

Vulva changes after weight loss can include loose or sagging skin and loss of fat volume in the mons pubis — the fatty mound above the pubic bone — and the labia majora, which are the outer lips of the vulva. 

While rapid weight loss from GLP-1 medications is a common context for Ozempic vulva, similar changes can occur after bariatric surgery or other methods that lead to fast, significant weight reduction.

Is Ozempic vulva a real side effect?

While “Ozempic vulva” is not a medically recognized side effect of taking GLP-1 medications, some people use this term to describe a variety of changes to the vulva and vagina during rapid weight loss. These changes can include differences in the look and shape of the vulva, skin texture, physical comfort, and vaginal moisture. 

For those who are already experiencing pelvic floor dysfunction — such as prolapse or urine leakage — these changes may also affect those symptoms. 

Causes of Ozempic vulva

Ozempic vulva can result from a combination of factors, including rapid loss of fat volume and skin elasticity in the vulvar region and hormonal and microbiome changes brought on by significant weight loss. Here’s more about factors that may contribute to Ozempic vulva:

• Loss of fat volume and skin elasticity. The mons pubis and labia majora are the fatty areas of the vulva that help give it its shape. When fat in these areas is lost faster than your skin can adjust — especially as your skin naturally loses collagen and elastin over time — the skin may not be able to shrink back fully. This can make the skin look loose, wrinkled, or saggy.

• Hormonal changes and microbiome shifts. Fat tissue plays a role in supporting your body’s hormone balance, including estrogen. When you lose a lot of fat quickly, your estrogen levels can dip, which may lead to more dryness or thinning in the vaginal area. Medications like Ozempic and other GLP-1s can also affect digestion and the balance of healthy bacteria in your gut (microbiome), which may impact vaginal health and make things like irritation or infections more likely. 

Rapid weight loss can cause muscle loss throughout the body and likely includes the pelvic floor muscles to some degree, which can contribute to Ozempic vulva symptoms. Reduced strength and support in the pelvic area may make it harder to control your bladder or could contribute to other pelvic symptoms, such as heaviness, discomfort, or changes in bowel or sexual function. On the other hand, some research shows that weight loss can sometimes bring improvement in pelvic health. More research is needed to understand these effects. 

“People are often surprised when they notice vulva changes, and it’s easy to think they’re caused by the medication,” says Dr. Toprani. “But many of these changes actually happen because of the rapid fat loss that comes with significant weight loss — not as a direct effect of the medication itself.” 

Regardless, there are things you can do to help you feel comfortable and supported in your body as it changes, says Dr. Toprani.

Symptoms of Ozempic vulva

Ozempic vulva can describe a range of changes, including differences in the look and shape of the vulva, skin texture, physical comfort, vaginal moisture, pelvic floor strength symptoms, and even changes in discharge or infection risk. Some of these are simply visual or physical changes in appearance, rather than symptoms or sensations you might feel. Here’s more about common physical changes and symptoms of Ozempic vulva:

• Visible reduction in vulvar fullness. The mons pubis (the fatty mound above the pubic bone) and outer labia (labia majora) may appear flatter, sagging, or puckered. When the outer lips get smaller, the inner lips (labia minora) may look more prominent or exposed.

• Loose or wrinkled skin. Excess skin may look wrinkly, saggy, or hang in folds.

• Discomfort during certain activities. Sitting, cycling, or wearing tight clothing may be less comfortable. Some people report chafing or irritation.

• Vaginal dryness or irritation. As estrogen levels drop with fat loss, vaginal tissues can become thinner and less lubricated, which may cause dryness or pain during sex.

• Pelvic floor symptoms. Possible muscle loss in the pelvic floor could lead to symptoms like urinary leakage, a sensation of heaviness, or a feeling of looseness in the vaginal canal. If you become constipated while taking GLP-1 medications, straining during bowel movements can sometimes make pelvic symptoms like prolapse or incontinence worse.

• Changes in discharge, odor, or infection. Shifts in the vaginal and gut microbiomes can make bacterial vaginosis or yeast infections more likely.

Not everyone who takes GLP-1 medications will experience these symptoms. Whether or not you notice changes can depend on such factors as your genetics, the speed of your weight loss, and the natural health and elasticity of your skin. These effects may be more pronounced in older people, as age-related loss of collagen and elastin can make the skin less able to adapt to rapid changes.

Treatments for Ozempic vulva

There are a variety of approaches to manage the cosmetic and functional changes associated with Ozempic vulva, including physical therapy and targeted exercises, staying active, using topical moisturizers and lubricants, focusing on hydration and nutrition, considering hormonal therapies, and — for those seeking cosmetic changes — elective treatments or surgical procedures. Here’s more about these treatment options:

• Physical therapy and targeted exercises. If you notice new or worsening pelvic symptoms after weight loss — like weakness, heaviness, or urine leakage — physical therapy and targeted exercises can help, especially if these issues are related to changes in pelvic floor muscles. While exercise can’t replace fat tissue lost around the vulva, strengthening your pelvic floor, glutes, hips, and core can help maintain support and function in the pelvic area. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. 

• Stay active. Targeted pelvic floor physical therapy exercises can help improve pelvic health, but any type of movement — like walking, stretching, or even household chores — can improve overall well-being and support skin and muscle health. Resistance (strength) training helps preserve lean muscle mass throughout your body, which provides underlying support for your skin and tissues. Engaging in regular physical activity also helps stimulate bowel function and support healthy digestion, which can help manage constipation, a common GLP-1 medication side effect. 

• Topical moisturizers and lubricants. Using over-the-counter vaginal moisturizers and vaginal lubricants can help relieve dryness, improve comfort, and support tissue health. Regular use of vaginal moisturizers can help with baseline dryness, while water-based lubricants can make intimacy more comfortable. These products can be helpful if you notice vaginal dryness or irritation from fat loss and lower estrogen levels. Look for pH-balanced, fragrance-free products designed for sensitive skin. Some contain extra-hydrating ingredients, like hyaluronic acid or natural oils, to further soothe and protect delicate tissue.

• Hydration and nutrition. Drinking plenty of water supports healthy, flexible skin and helps keep your vulva and vaginal tissues well-hydrated. Eating enough protein helps maintain muscle. Research suggests consuming 60-75 grams per day when taking GLP-1s to prevent muscle loss. Probiotics or prebiotic foods can help maintain a healthy gut and vaginal microbiome.

• Padded clothing for comfort. If you experience discomfort during activities such as biking or exercise, wearing more supportive clothing, like padded bike shorts, can help cushion sensitive areas, reduce friction, and make movement more comfortable.

• Hormonal therapies. For persistent vaginal dryness or discomfort, discuss vaginal estrogen therapy (creams or suppositories) or other hormone therapy options with your provider. These therapies can help restore moisture and improve the thickness and elasticity of vaginal tissues, which may be affected if your estrogen levels have dropped due to significant fat loss.

• Minimally invasive treatments. For those interested in addressing cosmetic changes, procedures like “labia puffing” with dermal fillers or fat transfer may help restore fullness. Energy-based treatments, such as radiofrequency, ultrasound, or laser, may also help with tightening skin. Data for these treatments are limited, and they are elective — not medically necessary.

• Surgical options. If severe sagging or dissatisfaction with appearance is a concern, elective surgeries such as labiaplasty (reshaping the labia), mons pubis lift (monsplasty), or fat grafting are available. These surgical options are not required for health reasons but may be considered if you want to address cosmetic issues.

“It’s completely normal for your body to change during weight loss,” says Dr. Toprani. Changes in your vulva’s appearance don’t mean anything is wrong with you, unless they come with other bothersome symptoms. 

“If you have uncomfortable symptoms, combining pelvic floor exercises with healthy habits and vaginal products can help,” says Dr. Toprani. “Cosmetic treatments are always a personal choice — you don’t need to consider them unless it’s something you truly want for yourself.”

Physical therapy for pelvic health

Physical therapy can play an important role in supporting your pelvic health, no matter where you are on your health journey. Working with a physical therapist can help you focus on safe movement and targeted exercises to build pelvic floor strength, improve coordination, and maintain your core and hip muscles. These fundamentals are important for pelvic health at any time — not just after significant weight loss. They can help address symptoms like pelvic pressure, bladder changes, and general discomfort, and are useful for anyone looking to feel stronger, more comfortable, and more confident in their daily activities.

A physical therapist (PT) can assess your movement patterns and pelvic health symptoms to create a personalized program for you. They can also provide practical tips for adjusting your daily activities and recommend strategies to reduce symptoms or help you feel your best, like teaching you how to engage your pelvic floor during movement, helping you improve your breathing and abdominal pressure management, and helping you pace new activities. 

If your weight loss is accompanied by pelvic floor symptoms like leakage or looseness, physical therapists may recommend exercises such as Kegels to help strengthen muscles that support the pelvic floor (see more exercises below). 

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

The above are foundational exercises for pelvic health that can benefit you regardless of your weight or how your body is changing. Practicing these moves regularly can help maintain muscle tone, support pelvic function, reduce pelvic symptoms, and improve comfort in everyday activities after weight loss. Moves like abdominal bracing and hooklying Kegels help you connect with your deep core and pelvic floor, while single leg RDLs, clamshells, and monster walks reinforce the muscles around your pelvis and hips. The Kegel bridge brings together pelvic floor activation with overall lower body strengthening for added support.

Rapid or significant weight loss can impact your muscle mass, which may lead to changes in muscle function and strength. “Focusing on these pelvic health exercises is a great way to support your body through big changes,” says Dr. Toprani. “Most people find that even a few minutes of practice a day can improve their comfort and confidence.”

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to prevent Ozempic vulva

There isn’t a lot of research yet on how to specifically treat or prevent Ozempic vulva. The following recommendations are general tips based on what’s known about managing similar body changes in people taking GLP-1 medications or experiencing rapid weight loss. Taking a proactive approach with gradual weight loss, targeted pelvic exercises, resistance training, adequate protein, hydration, microbiome support, and healthy lifestyle habits may all help reduce the risk or severity of Ozempic vulva as your body adapts to weight loss.

• Aim for gradual weight loss. Slower weight reduction may allow your skin and tissues more time to adapt. Discuss medication dose adjustment with your doctor if you’re losing weight rapidly.

• Start targeted pelvic exercises early. Pelvic floor movements like Kegels — and many other strengthening exercises — help maintain pelvic function and may prevent incontinence and other pelvic symptoms. Starting pelvic floor exercises early when beginning GLP-1 medications may help keep your pelvic floor muscles strong and healthy as your body adjusts to weight loss and possible muscle mass changes. By building a foundation of strength before any potential changes in vaginal tissue, muscle mass, or support occur, you may lower your risk of symptoms like bladder leakage, heaviness, or discomfort.

• Prioritize resistance training. Workouts that build strength — like lifting weights or using resistance bands — help preserve your overall muscle mass, especially around the hips and pelvis. Maintaining strong muscles supports the underlying structure of your vulva and pelvic area.

• Eat enough protein. Protein is essential for muscle repair and growth, making it a key part of maintaining muscle while taking GLP-1 medications, notes Dr. Toprani. Foods like lean meats, fish, eggs, dairy, tofu, legumes, and protein shakes can help provide the necessary building blocks for maintaining muscle. Aim to spread protein intake throughout the day to support consistent muscle growth. 

• Stay hydrated and support your skin. Water supports protein metabolism, nutrient absorption, and circulation, all of which contribute to muscle repair and growth. Proper hydration can also help maintain skin elasticity and muscle firmness, which may improve the appearance of sagging after weight loss. Aim to drink at least half your body weight in ounces of water each day to keep your muscles and tissues healthy.

• Support your microbiome. Eating probiotic-rich foods (like yogurt or kefir) and plenty of fiber can help maintain a healthy vaginal and gut environment.

• Prioritize healthy lifestyle habits. Quality sleep and effective stress management play important roles in overall health, including how your body adapts to weight loss. Aim for 7-9 hours of restful sleep each night to support muscle recovery, skin health, and hormone balance. Managing stress through activities like meditation, gentle movement, social connection, or deep breathing exercises can also help your body adjust more smoothly.

When to see a doctor

Ozempic vulva is usually a cosmetic issue that doesn’t require medical treatment. But if you have bothersome symptoms that are severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Persistent vaginal irritation, pain, or dryness that doesn’t improve with over-the-counter options

• New urinary leakage, heaviness, or a bulging sensation in the pelvic region

• Significant distress or discomfort about the cosmetic appearance of your vulva

• A history of pelvic floor dysfunction or pelvic surgery

• Worsening symptoms or concerns you feel are related to your weight loss medication

PT tip: Focus on strength and feeling good

“It’s easy to focus on changes in how your body looks, but try to pay attention to what matters most — like how your body feels and functions,” says Dr. Toprani. “Celebrate your progress and put your energy into building strength and supporting your pelvic floor. In the end, feeling good and moving well matter more than appearance.”

How Hinge Health can help you

If you have pelvic pain, bladder, bowel, or other pelvic symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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