The new CagriSema menopause results found substantial weight loss before, during and after menopause. They do not prove that menopause changes how well the medicine works. The headline estimate was 25.0% weight loss among women taking CagriSema, versus 3.0% with placebo, an inactive comparison treatment. That estimate assumes everyone stayed on treatment.
CagriSema combines cagrilintide, a long-acting lab-made version of the fullness hormone amylin, with semaglutide. Semaglutide copies GLP-1, a gut hormone involved in appetite and blood sugar. It is a two-drug treatment, so its results cannot be treated as results for semaglutide alone.
What the CagriSema menopause study reported
As of October 29, 2026, the day this article was written, Novo Nordisk's October 20 announcement reports two new analyses from REDEFINE 1. They were presented at The Menopause Society's annual meeting. Both were post hoc analyses: researchers returned to existing trial data to ask additional questions.
The original trial enrolled 3,417 adults with obesity, or overweight plus a related health condition, without diabetes. It followed treatment for 68 weeks, alongside lifestyle support (Garvey et al., New England Journal of Medicine, 2025).
There were 2,309 women across all four treatment groups. The CagriSema-versus-placebo comparison included 1,902 women: 1,441 receiving the combination and 461 receiving placebo. Their estimated average weight reductions were 25.0% and 3.0%.
That is about a quarter of starting body weight in the combination group. But the calculation matters. Novo calls it the efficacy estimand: an estimate assuming everyone stayed on treatment and used no other weight-loss therapies. It is not a forecast for everyone who starts a prescription.
Semaglutide is one ingredient; the cagrilintide explainer covers the other.
How the menopause groups were assigned
Researchers reconstructed reproductive stages afterward, using age, medical history and recorded symptoms. They did not collect a dedicated menopause assessment or hormone-test confirmation in advance.
The meeting abstracts, P-50 and P-51, report these estimated weight reductions at 68 weeks:
| Group | CagriSema | Placebo |
|---|---|---|
| Premenopausal, before the menopause transition | 26.7% | 2.1% |
| Perimenopausal, during the transition toward periods stopping | 24.8% | 1.7% |
| Postmenopausal, after menopause | 23.1% | 2.6% |
Women using hormone therapy, treatment that replaces hormones for menopause-related needs, were analyzed separately regardless of their stage. They were not folded into these three rows.
The combination group's figures were numerically lower after menopause. However, Novo says no formal interaction test was performed, meaning no formal test checked whether the treatment effect differed between subgroups. Age and other starting characteristics also differed. These comparisons cannot pin the difference on menopause itself.
What this means for someone already taking a GLP-1 medicine
The useful finding is that women after menopause still had substantial weight reductions compared with placebo. Menopause did not erase the average response in this analysis. Whether it independently reduces the size of that response remains unsettled.
Separate evidence points in a similar direction. A SURMOUNT analysis in Obesity, 2025 found weight reductions with tirzepatide across reproductive stages. It also reconstructed the groups afterward. That supports studying treatment across stages, without promising the same result for every woman.
The guides to semaglutide and menopause and tirzepatide and menopause cover those medicines' separate evidence. Tirzepatide also acts on GIP, another gut-hormone signal involved in blood-sugar control; it is not the CagriSema combination.
A separate October 20 observational study summary, following existing treatment choices, linked hormone therapy with greater sustained semaglutide weight loss, without a clear lasting tirzepatide difference.
What the headline does not establish
These results do not establish a menopause treatment or a reason to add hormone therapy for weight loss. They measure weight change, rather than demonstrating relief from hot flashes or other menopause symptoms.
The analyses were sponsor-funded conference findings, not full peer-reviewed reports, which independent experts check before publication. The main REDEFINE 1 trial has been published, but that does not give every later subgroup claim the same footing. Novo itself calls the new analyses "hypothesis-generating": they suggest questions that need more testing.
They also do not rank CagriSema against tirzepatide for women after menopause. The CagriSema versus tirzepatide comparison explains the separate studies behind that question.
Side effects still belong beside the headline. Adverse events are health problems occurring during treatment, whether or not the medicine caused them. Novo's October 20 release gives these figures for the whole REDEFINE 1 trial, not specifically for postmenopausal women:
| Event | CagriSema | Placebo |
|---|---|---|
| Gut side effects | 79.6% | 39.9% |
| Nausea | 55.0% | 12.6% |
| Stopping treatment because of adverse events | 5.9% | 3.5% |
About four in five combination recipients reported gut symptoms. Most were temporary and mild or moderate. The stage analysis does not establish a separate side-effect rate for each menopause group.
Nor does a trial of Novo's combination establish results for a compounded preparation. Semaglutide and tirzepatide prescribed through Promise are dispensed by a licensed U.S. compounding pharmacy as compounded medications, which is different from an FDA-approved product: the formulations offered here are not FDA-approved.
The FDA's compounding explanation, marked current September 16, 2025, states that it does not review compounded drugs for safety, effectiveness or quality before marketing. A licensed provider may still prescribe — that decision is between you and your doctor.
At Promise, a licensed U.S. provider reviews every request, and not everyone qualifies.
What to watch next
As of October 29, 2026, the day this article was written, Novo's announcement today says CagriSema is not approved in the United States or anywhere else. Its October 20 release says the US weight-management application was filed in December 2025, with a decision expected in the fourth quarter of 2026. That is an expected decision window, not a promised outcome.
Today's announcement also previews more CagriSema research at ObesityWeek, November 14–17, including quality-of-life findings. Those presentations are still ahead.
For the menopause question, a full publication and studies that define reproductive stage before enrollment would help. The question is whether stage changes treatment response independently of age and other differences, alongside how tolerable treatment is.
