Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.

We’ve heard a lot about the impacts of Ozempic recently, from rapid weight loss and lowered blood pressure, to persistent vomiting and “Ozempic face”.

Now we’re seeing a rise in stories about “Ozempic babies”, where women who use drugs like Ozempic (semaglutide) report unexpected pregnancies.

But does semaglutide (also sold as Wegovy) improve fertility? And if so, how? Here’s what we know so far.

Remind me, what is Ozempic?

Ozempic and related drugs (glucagon-like peptide-1 receptor agonists or GLP-1-RAs) were developed to help control blood glucose levels in people with type 2 diabetes.

But the reason for Ozempic’s huge popularity worldwide is that it promotes weight loss by slowing stomach emptying and reducing appetite.

Ozempic is prescribed in Australia as a diabetes treatment. It’s not currently approved to treat obesity but some doctors prescribe it “off label” to help people lose weight. Wegovy (a higher dose of semaglutide) is approved for use in Australia to treat obesity but it’s not yet available.

How does obesity affect fertility?

Obesity affects the fine-tuned hormonal balance that regulates the menstrual cycle.

Women with a body mass index (BMI) above 27 are three times more likely than women in the normal weight range to be unable to conceive because they are less likely to ovulate.

The metabolic conditions of type 2 diabetes and polycystic ovary syndrome (PCOS) are both linked to obesity and fertility difficulties.

Women with type 2 diabetes are more likely than other women to have obesity and to experience fertility difficulties and miscarriage.

Similarly, women with PCOS are more likely to have obesity and trouble conceiving than other women because of hormonal imbalances that cause irregular menstrual cycles.

In men, obesity, diabetes and metabolic syndrome (a cluster of conditions that increase the risk of heart disease and stroke) have negative effects on fertility.

Low testosterone levels caused by obesity or type 2 diabetes can affect the quality of sperm.

So how might Ozempic affect fertility?

Weight loss is recommended for people with obesity to reduce the risk of health problems. As weight loss can improve menstrual irregularities, it may also increase the chance of pregnancy in women with obesity.

This is why weight loss and metabolic improvement are the most likely reasons why women who use Ozempic report unexpected pregnancies.

But unexpected pregnancies have also been reported by women who use Ozempic and the contraceptive pill. This has led some experts to suggest that some GLP-1-RAs might affect the absorption of the pill and make it less effective. However, it’s uncertain whether there is a connection between Ozempic and contraceptive failure.

In men with type 2 diabetes, obesity and low testosterone, drugs like Ozempic have shown promising results for weight loss and increasing testosterone levels.

Avoid Ozempic if you’re trying to conceive

It’s unclear if semaglutide can be harmful in pregnancy. But data from animal studies suggest it should not be used in pregnancy due to potential risks of fetal abnormalities.

That’s why the Therapeutic Goods Administration recommends women of childbearing potential use contraception when taking semaglutide.

Similarly, PCOS guidelines state health professionals should ensure women with PCOS who use Ozempic have effective contraception.

Guidelines recommended stopping semaglutide at least two months before planning pregnancy.

For women who use Ozempic to manage diabetes, it’s important to seek advice on other options to control blood glucose levels when trying for pregnancy.

What if you get pregnant while taking Ozempic?

For those who conceive while using Ozempic, deciding what to do can be difficult. This decision may be even more complicated considering the unknown potential effects of the drug on the fetus.

While there is little scientific data available, the findings of an observational study of pregnant women with type 2 diabetes who were on diabetes medication, including GLP-1-RAs, are reassuring. This study did not indicate a large increased risk of major congenital malformations in the babies born.

Women considering or currently using semaglutide before, during, or after pregnancy should consult with a health provider about how to best manage their condition.

When pregnancies are planned, women can take steps to improve their baby’s health, such as taking folic acid before conception to reduce the risk of neural tube defects, and stopping smoking and consuming alcohol.

While unexpected pregnancies and “Ozempic babies” may be welcomed, their mothers have not had the opportunity to take these steps and give them the best start in life.

Read the other articles in The Conversation’s Ozempic series here.

Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University and Robert Norman, Emeritus Professor of Reproductive and Periconceptual Medicine, The Robinson Research Institute, University of Adelaide

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Everyone seems to have a different opinion when it comes to how often towels and bed sheets should be washed. While many people might wonder whether days or weeks is best, in one survey from the United Kingdom, almost half of single men reported not washing their sheets for up to four months at a time.

It’s fairly clear that four months is too long to leave it, but what is the ideal frequency?

Bed linen and towels are quite different and so should be washed at different intervals. While every week or two will generally suffice for sheets, towels are best washed every few days.

Anyway, who doesn’t love the feeling of a fresh set of sheets or the smell of a newly laundered towel?

Why you should wash towels more often

When you dry yourself, you deposit thousands of skin cells and millions of microbes onto the towel. And because you use your towel to dry yourself after a shower or bath, your towel is regularly damp.

You also deposit a hefty amount of dead skin, microbes, sweat and oils onto your sheets every night. But unless you’re a prolific night sweater, your bedding doesn’t get wet after a night’s sleep.

Towels are also made of a thicker material than sheets and therefore tend to stay damp for longer.

So what is it about the dampness that causes a problem? Wet towels are a breeding ground for bacteria and moulds. Moulds especially love damp environments. Although mould won’t necessarily be visible (you would need significant growth to be able to see it) this can lead to an unpleasant smell.

As well as odours, exposure to these microbes in your towels and sheets can cause asthma, allergic skin irritations, or other skin infections.

So what’s the ideal frequency?

For bedding, it really depends on factors such as whether you have a bath or shower just before going to bed, or if you fall into bed after a long, sweaty day and have your shower in the morning. You will need to wash your sheets more regularly in the latter case. As a rule of thumb, once a week or every two weeks should be fine.

Towels should ideally be washed more regularly – perhaps every few days – while your facecloth should be cleaned after every use. Because it gets completely wet, it will be wet for a longer time, and retain more skin cells and microbes.

Wash your towels at a high temperature (for example, 65°C) as that will kill many microbes. If you are conscious of saving energy, you can use a lower temperature and add a cup of vinegar to the wash. The vinegar will kill microbes and prevent bad smells from developing.

Clean your washing machine regularly and dry the fold in the rubber after every wash, as this is another place microbes like to grow.

Smelly towels

What if you regularly wash your towels, but they still smell bad? One of the reasons for this pong could be that you’ve left them in the washing machine too long after the wash. Especially if it was a warm wash cycle, the time they’re warm and damp will allow microbes to happily grow. Under lab conditions the number of these bacteria can double every 30 minutes.

It’s important to hang your towel out to dry after use and not to leave towels in the washing machine after the cycle has finished. If possible, hang your towels and bedding out in the sun. That will dry them quickly and thoroughly and will foster that lovely fresh, clean cotton smell. Using a dryer is a good alternative if the weather is bad, but outdoors in the sun is always better if possible.

Also, even if your towel is going to be washed, don’t throw a wet towel into the laundry basket, as the damp, dirty towel will be an ideal place for microbes to breed. By the time you get to doing your washing, the towel and the other laundry around it may have acquired a bad smell. And it can be difficult to get your towels smelling fresh again.

What about ‘self-cleaning’ sheets and towels?

Some companies sell “quick-dry” towels or “self-cleaning” towels and bedding. Quick-dry towels are made from synthetic materials that are weaved in a way to allow them to dry quickly. This would help prevent the growth of microbes and the bad smells that develop when towels are damp for long periods of time.

But the notion of self-cleaning products is more complicated. Most of these products contain nanosilver or copper, antibacterial metals that kill micro-organisms. The antibacterial compounds will stop the growth of bacteria and can be useful to limit smells and reduce the frequency with which you need to clean your sheets and towels.

However, they’re not going to remove dirt like oils, skin flakes and sweat. So as much as I would love the idea of sheets and towels that clean themselves, that’s not exactly what happens.

Also, excessive use of antimicrobials such as nanosilver can lead to microbes becoming resistant to them.

Rietie Venter, Associate professor, Clinical and Health Sciences, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.