Mounjaro was one of the most talked about prescription medications of 2022. As I have been part of that conversation so I think it’s only fair to share my journey. Originally developed as a treatment for Type 2 diabetes the clinical research trials showed incredible weight loss results and it quickly gained popularity with this off label use. While many people started their Mounjaro journey with a desire to loose weight my journey started as an attempt to help my fertility.
To explain my situation let me give a little back story. In 2020 I suffered a pregnancy loss from an ectopic pregnancy ( I share more about this experience here) and although this isn’t something I would ever recommend doing I started my TTC journey even though I hadn’t been to an obgyn in years. Back in 2012 before I even knew my husband I went through a breakup and it was pretty clear to me that the person I had shared my bed with the prior year was not trustworthy. So being a smart woman looking out for my own wellbeing I made an appt with my then obgyn requesting testing for a full panel of STDs. Imagine my shock when I went in for that appointment and I was taken to the nurses area for my blood pressure check and tapped up on the cabinet was a list of all the patient appointments for the day – names and reason for visit. Needless to say I was not please to see my name and STD posted for any patient to see and I lost all trust in that obgyn office (in case you were wondering my test results did come back negative, whew). Years passed by and finding a new obgyn was something I kept meaning to do but it was never really pressing. By that time I was in a committed relationship with my now husband, was not interested in birth control and had no issues to cause me concern. But, that is how I wound up needing an obgyn referral for my post op care.
I lucked out and really liked the obgyn I was referred to so I decided make her my regular dr. Dr.M is kind, understanding and pretty much everything I think a woman could want in her obgyn. She was also great at encouraging me that I could resume TTC once I was fully healed and I did do with her blessing three months post op. At the five month post op mark I stopped having my period and was super excited to think I was pregnant again and called for a check up. Sadly Dr.M was not in that week but one of her male colleagues made room to see me. Unfortunately I was not pregnant and he suspected I was not ovulating; he immediately brought up my weight as the likely cause. Now, I am not disagreeing that a high weight can cause issues with ovulation but I also know there can be a fat bias in medicine where drs are quick to blame issues on weight rather than investigating other causes and I did push back. I had not suddenly become overweight, I have been overweight my entire post puberty life and obese most of my adult life and until my ectopic pregnancy I had never once in my entire life skipped a period. So, I wanted to know why my weight would suddenly cause this issue. He answered that stress could also be a contributing factor and well, I was certainly under a lot of stress in my life. He prescribed me progesterone to trigger a cycle and said if I wanted he could do mire testing but it was “very expensive” and had a pretty discouraging tone about it. Real talk – that dude was a dick! But I left with my prescription and told myself I needed to loose weight and stress less.
The progesterone initially worked and I had two more cycles. Because I really didn’t want to go see Dr. dick again I used Modern Fertility at home testing (more about that experience here) and received results indicating I was struggling with my fertility. Meanwhile, the reducing stress part wasn’t so easy. I don’t want to get into all the details I did have a bit of a breakdown in March and again I stopped cycling. I sought counseling and decided instead of pumping myself full of hormones to force what my body clearly didn’t want to happen to focus on my mental health and see if my body would start cycling naturally again. It took 7 months but eventually I did and it seemed like my body had reset itself. I started daily ovulation tests and we were once again TTC. This went on for another seven months and then no period, negative pregnancy tests and no positive ovulation strips. I felt like I was in a much better mental health space than a year before and I was past due for my annual exam so I decided it was time to see Dr.M again.
Dr.M agreed it was puzzling that I once again stopped ovulating, confirmed everything looked good on my physical exam , gave me another prescription for progesterone and set up an appointment to do a full run up of labwork (sidenote to dr.dick, I didn’t pay a penny out of pocket for this). When I failed the progesterone challenge she also scheduled me for an ultrasound to look for ovarian cysts. At this point I was referred to an Endocrinologist- Dr.M said I checked some but not enough of the boxes for PCOS so she wanted a 2nd opinion. My results showed high prolactin, high glucose and an A1C in the pre diabetic range which indicated I have insulin resistance. Since I had failed to have another cycle she recommended I take birth control for the next six months.
It took two months to get into the endocrinologist but in the meantime I took the birth control and changed my diet to reduce sugar and carbs to help with the insulin resistance. I was able to loose 12 lbs in those two months and lower my glucose levels to not great but not as alarming. During my first meeting with Dr.B I brought up Mounjaro as I had seen it on social media and it sounded like a good fit , she said I read her mind as she was looking for patients to test it on but cautioned that there was no studies on the effect on pregnancy so I would have to be ok pausing my TTC journey. I had another four months of birth control to take anyway so I figured it was worth a shot so I committed to a six month pause and then we could reevaluate.
On Sept 1st 2022 I administered my first injection of the loading dose (2.5 mg) of Mounjaro after a low fat, low carb dinner as recommended by Dr.B. The next morning I immediately noticed a difference, it’s not like I usually woke up starving but this feeling was different – I just had no interest in food. I had to remind myself to eat and there were days that first week when I would just completely forget to eat until dinner; this of course made me pretty tired and I knew it wasn’t healthy so I started borrowing from my husband’s stash of protein shakes and pretty quickly decided I needed a stash of my own. I’ve pretty much had a protein shake every single day since starting on this journey. In the past dieting had caused me lots of problems because I also suffer from chronic migraines and skipping meals is often a migraine trigger but amazingly on Mounjaro I was doing ok as long as I started my day with a shake. I quickly fell into a routine of protein shake in the AM, a small afternoon snack and a low carb / ketoish dinner. I was occasionally nauseous and if I ate too heavy of a meal I would throw up. I felt like I got a handle on what I could and couldn’t eat pretty quickly and the biggest adjustment was that I was not going #2 daily; in the beginning I did occasionally feel cramps from this but it wasn’t too bad and only lasted the first month.
I went back to see Dr.B after four weeks and she was happy to see that I had lost another 12lbs and prescribed me the first “regular” dose of Mounjaro (5mg). She cautioned me to be careful as I was doubling my dosage and to make sure I didn’t eat to the point of making myself sick as people had been hospitalized for dehydration due to the excessive vomiting on this medication. Surprisingly increasing the dosage did not increase the side effects, in fact I slowly started gaining my appetite back. I didn’t loose or gain anything the first three week on 5mg but after enjoying a four course dinner during a weekend getaway I felt like I was wasting time on the 5mg and sent Dr.B a message explaining the situation and asking to go up to the 7.5mg and she agreed.
I started the 7.5mg on Oct 21st and while 5mg had been too little appetite suppression the 7.5mg was too much. I could barely eat a few bites of food before feeling sick and even though I was eating very little I started throwing up as if I had gorged on a large meal. The first few weeks I wound up having to switch to a liquid diet of only protein shakes and broccoli cheddar soup just so I could keep down some nutrition. I was incredibly weak, exhausted and nauseous 24 hours a day. I lost 9 lbs the last 10 days of October alone! In November movement on the scale slowed as I imagine my body was fighting to hold onto whatever I could manage to consume. But, around the 4th week it started to get better and while the few days after the injection were miserable I could eat on days 6 and 7. Interestingly I probably consumed the least calories in November but it was the month I lost the least – only 7 lbs. I lost count of how many times I vomited in November but it was a lot, and I had nine migraines that month. But I was determined to push through and hoped it got better.
By mid December I felt like my body had adjusted to the 7.5 and while the amount was smaller around injection days I was able to eat actual food everyday and I only threw up twice that month. I was still getting migraines but it was getting better. At this point Mounjaro had become widely popular and it was out of stock in several doses nationwide including the 7.5mg. My pharmacy called me and let me know they couldn’t get the 7.5mg until January but they could get the 10mg. I once again messaged Dr.B and she agreed to increase my dose. It was now the week of Christmas and I had a conundrum – we were traveling to Chicago and the last thing I wanted was to be miserably sick like the last time I had increased. But, I had one 5mg leftover I could take before going up to the 10mg. I decided to take the 5mg and enjoy my week of a more normal appetite in the Windy City. I decided to eat whatever the heck I wanted and while I feel like I still ate less than I did pre Mounjaro I gained 3lbs as a result. While many people taking Mounjaro strictly for weight loss report being able to eat whatever they want as long as the keep their calories in check I have realized that with insulin resistance I am not so lucky. I think it’s ok to let loose once in a while but the reality is I will probably need to eat low carb for the rest of my life.
After we returned home I had another follow up visit with Dr.B and my A1C was checked; ta-da! I was back in the normal range and no longer considered pre-diabetic. At this point Dr.B, knowing my real goal is pregnancy and not a smaller dress size asked if I wanted to keep going. I had the four 10mg injections waiting for me at home and I wanted to take them. As supply has continued to be a struggle and there’s been pharmacies refusing to fill prescriptions for people without Type2 we talked about possible alternatives but the reality Dr.B said is that nothing is going to be as good as Mounjaro. I talked about my hopes in seeing a fertility specialist, ideally in April of this year. Dr.B provided feedback that a fertility specialist is going to want to see me reduce as much weight as possible so we agreed that as long as I can get it I will take Mounjaro at least through March. I will go back for full lab work so I can go into my fertility appointment with that information and then that Dr will advise on a future course of action.
At the end of December I hit 10lbs loss for the month which put me down a total of 50lbs lost in 2022 (but honestly I think not being pre diabetic is the biggest win). If I can maintain 10lbs / average a month loss that would put me 80lbs down by the time I see a fertility specialist and based on the research I’ve done that would put me in range or close to the range of being a candidate for IUI. The birth control did get me to regulate my cycle so I’m also ready to see if with my insulin resistance being treated I can continue to have regular cycles and maybe, just maybe I can get pregnant without intervention.
My Mounjaro journey hopefully isn’t over but if it ends this month I can be at peace with that. To the outside world the 50 lb weight loss is noticeable. Surprisingly for the first time in my life the weight seems to be coming off my stomach first. My breasts are still pretty large and my hips are still wide so while my hourglass figure in more pronounced I’ve only gone down a size and can still make a lot of my clothes work by belting the waist or wearing skirts a little lower on the waist. To me the real change is on the inside, with improved lab results but also an improved attitude. I spent 2020 and 2021 angry at how unfair life was being to me, frustrated every-time I tried to eat less and workout more only for nothing to change, pissed as hell every time I saw a plus size woman announce her pregnancy wondering why her but not me? I went into my appointment with Dr.M this past spring feeling hopeless, ready to hear her tell me that she was sorry but I didn’t have any chance of conceiving. This journey has been hard – there were days I considered quitting this medication, times when I thought that surely my body could not survive the vomiting, the constant nausea and the pain from the headaches. But I pushed through and my reward is that I have something I haven’t had these past few years – hope.