Love it or hate it, Ozempic and similar weight loss drugs have become a part of queer culture. While currently there are no published studies detailing the rate of use in the queer community, anecdotally it's everywhere. Queer celebs including Jonathan Van Ness, Boy George, Rosie ODonnell, Harvey Fierstein, and the list goes on, have all discussed having used the medication.Ozempic, aka semaglutide, is the most prominent member of a class of drugs called GLP-1 receptor agonists (others include Mounjaro, Zepbound, and Saxenda), which were originally approved for use in treatment of type-2 diabetes, but have since been approved in larger doses as a weight loss drug. They work by mimicking the GLP-1 hormone, which naturally occurs in our bodies and regulates blood sugar and appetite.While many taking GLP-1s have had success in reducing weight, it can happen quickly, and that can come with some surprising side effects.Chances are youve heard of Ozempic face, which is caused by rapid weight loss and makes the face appear more gaunt, wrinkled, and older because of loss of volume. But what you may not realize is that there is also a growing number of GLP-1 users who are reporting an unexpected side effect, ahem, down there. It has come to be known as Ozempic vulva.To get to the, well, bottom of things, PRIDE spoke with medical experts Dr. David Shafer, a double board-certified plastic surgeon and founder of Shafer Clinic in New York City; Dr. Pamela Tambini, MD, the Medical Director at Engage Massachusetts; and Kiara DeWitt, founder and CEO of Injectco and accredited master nurse injector, about what causes Ozempic vulva, its potential treatments, and if there is a male equivalent. Spoiler alert: There is.Heres what they had to say.What is 'Ozempic vulva' and how common is it?While Ozempic and GLP-1 treatments have proven to be powerful weight loss treatments, Dr. Shafer tells PRIDE saggy skin is one of the consequences of extreme weight loss everywhere. With rapid weight loss or weight loss in general, the tissue of the female genital area can lose volume, leading to a saggy or deflated appearance, he says.What this means, Dr. Tambini tells PRIDE, is that the labia majora appears thinner or deflated. There is increased visibility of the labia minora due to a reduction in surrounding fat, the skin can loosen or wrinkle as a result and occasionally, there is increased sensitivity or discomfort due to less cushioning. Rapid weight loss can cause fat loss in the fat pads of the mons pubis and labia majora, which makes the skin looser and deeper structures to become more visible. It manifests as a flatter, less cushioned look, she adds.While all the experts agree this is a risk with GLP-1 use, they are unclear about just how common this side effect is, because, well, no one really likes to talk about it, DeWitt tells PRIDE. But anecdotally and by frequency of similar complaints vaginal laxity, dryness, dermal thinning, etc. Id say its not rare, just underreported.This is compounded, DeWitt says, because some women dont link these changes to the medication. This misinformation only breeds shame and, frankly, a general lack of patient advocacy for safe, restorative options.Is it simply an aesthetic issue, or could it create medical concerns as well?While the experts agree that Ozempic vulva is typically more of an aesthetic issue, they note there are circumstances where it can also raise medical concerns.In some cases, it can create functional concerns like sensitivity, discomfort, dryness, or irritation due to less cushioning in the pubic area, warns Dr. Tambini. These effects arent dangerous but may impact quality of life and sexual health.Adding to this, DeWitt points to the potential hormonal impacts tied to the loss of subcutaneous fat and the sudden shift in estrogen regulation. When estrogen levels fall or simply fat loss outpaces dermal recovery the surrounding soft tissue can take on a nearly hollowed out appearance. This can be noticed with hygiene, intercourse, or even sitting in ways which are not subtle. She continues, When that tissue is thinned or lost, protection and temperature regulation as well as moisture balance can all be impacted.Is there a male equivalent?Does this impact LGBTQ+ people at a higher rate?Ozempic vulva is something that impacts folks with vaginas; however, the experts say that people with penises have an equivalent side effect. It is referred to as what some might label an Ozempic penis or, more anatomically, pubic deflation, says DeWitt. Same logic applies. As fat drains away, the soft scaffolding alters. Again, like I said, this is not dangerous, but it does change the visual proportions of the area.In [people with penises] the rapid fat loss can noticeably affect the genital and pubic region in a similar way, adds Dr. Tambini. [They] lose fat in the mons pubis/suprapubic region which can make the penis appear longer or more prominent and sometimes more deflated or saggy. The scrotum may also look looser or more wrinkled.What can be done to combat Ozempic vulva?While all vulvas are unique and beautiful, for those unhappy with their appearance or experiencing some of the medical impacts of rapid weight loss on their vulvas volume, there are some things that can be done, say the experts:Labia puffing, which is adding fillers to the labia.Sculptra, which is a biostimulant, may be useful to rebuild volume and improve skin integrity.Topical estrogen to improve skin thickness.Fat grafting.AlloDerm, which utilizes donor tissue.CO2 laser and radiofrequency to help stimulate collagen to strengthen the skin.Hormonal therapy to address discomfort and dryness.Whatever course of treatment is followed, its very important for patients to see a qualified and experienced injector such as a plastic surgeon or GYN who specializes in these treatments, advises Dr. Shafer.Ultimately, DeWitt explains that weight loss has always had systemic effects, its just that semaglutide accelerates the process. The faster you go, the more unexpected things happen. She adds that impacts like Ozempic vulva and Ozempic penis highlight the importance of patients understanding what all over fat loss means. As it turns out, the fat will disappear where it damn well pleases, not where we want it to. Just sayin if youre going to hasten body transformation with medicine, at least accept that the whole body will shift with it.Experts cited: Dr. David Shafer, a double board-certified plastic surgeon and founder of Shafer Clinic in New York CityDr. Pamela Tambini, MD, Medical Director at Engage Massachusetts in Acton, MA. Kiara DeWitt, founder and CEO of Injectco and accredited master nurse injector