{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:07:57Z","timestamp":1789546077191,"version":"build-2803163510"},"reference-count":17,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is widely used for obesity and type 2 diabetes management, but its gynecological adverse effects have not been systematically described. We report a 58-year-old postmenopausal woman with new-onset vaginal bleeding six weeks after starting semaglutide for weight reduction, with onset following dose escalation to 0.5\u2005mg weekly. Hemoglobin fell from 12.9\u2005g\/dL (Syst\u00e8me International [SI]: 129\u2005g\/L) to 10.8\u2005g\/dL (SI: 108\u2005g\/L) (reference range, 12.0-16.0\u2005g\/dL [SI: 120-160\u2005g\/L]). The serum follicle-stimulating hormone (FSH) concentration was elevated at 68.4\u2005mIU\/mL (SI: 68.4\u2005IU\/L; reference, &amp;gt;25\u2005IU\/L postmenopausal), and estradiol was suppressed at 3.5\u2005pg\/mL (SI: 13\u2005pmol\/L; reference, &amp;lt;5.4\u2005pg\/mL [SI: &amp;lt;20\u2005pmol\/L]), consistent with stable postmenopausal status throughout, without hormonal reactivation (no return toward a premenopausal pattern). Endometrial malignancy, structural pathology, and coagulopathy were excluded. The Naranjo Adverse Drug Reaction Probability Scale score was 6 (\u201cprobable\u201d). Bleeding resolved completely within five weeks of discontinuation. We propose that rapid semaglutide-induced adipose loss may transiently alter peripheral estrogen metabolism, destabilizing the endometrium despite unchanged hormone levels. This case highlights postmenopausal bleeding as a rare but clinically important adverse effect of GLP-1 receptor agonist therapy warranting malignancy-first evaluation.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag261","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:41:51Z","timestamp":1787398911000},"source":"Crossref","is-referenced-by-count":0,"title":["Postmenopausal bleeding associated with semaglutide: a diagnostic challenge"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0817-6439","authenticated-orcid":false,"given":"Sai","family":"Prasad","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, S. Nijalingappa Medical College , Navanagar, Bagalkote, Karnataka 587103 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidhi","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Mayo Clinic , Rochester, MN 55905 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anukriti","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jaipur National University Institute of Medical Sciences and Research Centre , Jaipur, Rajasthan 302017 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navjot","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Government Medical College Patiala , Patiala, Punjab 147001 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darpan","family":"Kothia","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ascension Sacred Heart Pensacola, Florida State University , Pensacola, FL 32504 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deep","family":"Bavaria","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, MP Shah Government Medical College , Jamnagar, Gujarat 361006 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"10192","key":"2026091603520379100_luag261-B1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0140-6736(19)31271-1","article-title":"Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a 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