These women finally found a treatment that worked for PCOS. Why won't insurance cover it?

Shelby Hatcher had tried everything. 

She used various methods of birth control — the pill, and then an intrauterine device (IUD) for 10 years. Her periods had been irregular since she was a teenager, but she wasn’t diagnosed with polycystic ovarian syndrome (PCOS) until she tried to have a baby. 

After having her IUD removed in May 2024, Hatcher had a period that lasted 45 days, and started experiencing symptoms of PCOS, such as fatigue and irregular menstrual cycles. 

She was put on Letrozole to regulate her period, which works by reducing estrogen levels in the body, but it was ineffective. Her OBGYN told her she had two options: Go back on birth control to regulate her hormones before trying to conceive again, or “lose weight.” 

The catch? Weight loss can help mitigate the symptoms of PCOS, but it won't necessarily address the hormonal imbalances associated with the condition, which make it difficult to lose weight.

PCOS affects 8%-18% of reproductive-aged women. On average, women visit three or more health professionals before a diagnosis is established. Weight and gender bias play a crucial role in this diagnostic delay, as women with PCOS often suffer from weight-centric health care.

If PCOS is left untreated, women are at increased risk of high blood pressure, cardiovascular disease, gestational diabetes and high cholesterol. Women with PCOS may also be at a greater risk for type 2 diabetes if they experience insulin resistance, in which blood sugar levels may rise. 

Dr. Hayley Miller, the medical director of Nurx Weight Management, says GLP-1s, such as Ozempic and Mounjaro, are a viable treatment option for managing PCOS metabolic symptoms, but most insurance companies are not willing to cover them without approval from the Food and Drug Administration (FDA).

In April 2025, Hatcher sought a GLP-1 prescription from an outside weight management provider. For a three-month supply, she is shelling out $1,400. 

Likewise, Tahira Adaya, 35, says Zepbound is a “miracle solution” for her decades-long struggle with PCOS and irregular periods. Adaya has PCOS in her diagnostic code, but pays $350 per month for the GLP-1 drug through the online pharmacy LillyDirect.

"I'm hoping the insurance policy will change soon, but I'm glad to have that on my record now," Adaya says. "It feels like 1 in 10 women having PCOS should be enough to move the needle on what gets covered with insurance, but it is a messy system."

For those who can afford to pay out-of-pocket costs, GLP-1s are “worth it,” Adaya says. But when the cost of treatment breaks the bank, other patients are left searching for insurance loopholes or stuck without the medication at all.

Women’s health conditions are under-researched and undertreated 

The FDA approves medications for condition-specific use, which informs insurance companies’ coverage policies. Even when medications are covered, insurance companies can also refuse to cover certain conditions. 

But when it comes to device testing and clinical trials for medical products marketed towards women, the administration falls short. 

“It does feel like the system just doesn’t think specifically about the very particular needs of women’s bodies and doesn’t do enough research into this,” FDA Commissioner Marty Makary told Politico in July 2025.

Dr. Jennifer Peña, chief medical officer at Wisp, says the data specifically on women of reproductive age is lacking.

"We really need a lot more studies focused on GLP-1 use in this particular patient population, because the majority of what we have is on older adults and diabetes," she says.

Another popular drug for treating PCOS is Metformin, which Hatcher and Adaya both used. Hatcher calls it the "worst medication I've ever taken," but it's "infinitely cheaper" than GLP-1s and similarly addresses insulin resistance, Peña says.

Peña says when Metformin doesn't work, GLP-1s are a valid next step. Her main concern is when they are offered as a first-line solution.

"You cannot say the GLPs are gonna fix the entire problem, because PCOS is not a one-size-fits-all type of condition," Peña says. "GLPs have an important role, but we have to be thoughtful about how we're going to use it and personalize it to the patient."

GLP-1s help PCOS symptoms, but stigma remains

Online, women with PCOS turn to subreddits and Facebook support groups to seek advice on GLP-1s. They offer each other encouragement and reassurance in the comments of posts from new GLP-1 users, and practical advice for those struggling to obtain affordable prescriptions. But offline, Adaya says there's still a stigma, and people don't understand that she is taking the drug to treat her PCOS symptoms.

"Sometimes when you tell people you're taking it for PCOS, they still think that you're doing it for vanity reasons," she says.

Adaya was diagnosed with PCOS at 27 after several visits with primary care specialists, gynecologists and endocrinologists, and her primary symptom has always been irregular periods. Her weight has fluctuated, but she's never been obese. While she has lost some weight since starting Zepbound in 2024, she says it's not as dramatic as other people have experienced.

"My period has never been regular in my entire life, until this past year. And so it feels to me like a miracle drug and solution," she says.

Adaya thinks about the cost often. She lives in New York, where the cost of living is already high, and compares the $350 per month to what she could be spending on a car payment or putting into her savings.

But she tries to look at the silver lining.

"Being on this drug now probably means I will be spending less in the future on my health in general," she says. "My irregular cycle was a big source of stress for me, and I am, for the first time in my life, living without this big source of stress."