Everything You Need to Know About Compounded Semaglutide for Midlife Women

You’ve probably heard of semaglutide by now.

Maybe a friend lost weight on it. Maybe you’ve seen it all over your feed — Wegovy, Ozempic, and now... compounded?

It’s a lot to take in, especially when your body is already changing in midlife and the scale hasn’t budged in years.

Here’s the good news: You don’t have to figure it all out on your own.

In this guide, we’ll walk you through what semaglutide actually is, why compounded versions exist, and why so many women in their 40s, 50s, and 60s are choosing a slower, more personalized approach. One that works with your hormones, not against them.

Let’s clear it all up, together.

Josie’s TL;DR

• Compounded semaglutide is a personalized version of the active ingredient in Ozempic® and Wegovy®, designed to fit your body’s needs — especially in midlife.
• It can be started at lower doses to reduce side effects and support your metabolism during perimenopause and postmenopause.
• You can choose between oral or injectable formats, depending on what feels right for your lifestyle and symptoms.
• Josie offers provider-guided care with symptom-based dosing, coaching, and support — so you’re never doing it alone.

What Is Semaglutide, Exactly?

Semaglutide is a medication that was originally created to help people manage type 2 diabetes. But doctors and patients started noticing something else — it also helped reduce appetite and led to steady weight loss.

It works by mimicking a natural hormone in your body called GLP-1, or glucagon-like peptide-1. That hormone helps you feel full faster, slows down how quickly food leaves your stomach, and keeps blood sugar more stable after eating.

For many women in midlife, that’s exactly the kind of support they’ve been looking for.

You may recognize semaglutide by its brand names: Ozempic (used for diabetes) and Wegovy (approved for weight loss). Both have become household names, but they’re not the only way to access the medication.

Here’s what semaglutide does in simple terms:

• Calms hunger and food cravings
• Slows digestion, so you feel fuller longer
• Reduces blood sugar spikes and crashes
• Helps support steady, sustainable fat loss

Next, we’ll explain how compounded semaglutide fits in — and why so many women over 40 are choosing it.

What’s the Difference Between Compounded and Brand-Name Semaglutide?

If you’ve heard of Ozempic or Wegovy, you’ve already heard of semaglutide. These are the brand-name versions — FDA-approved, mass-produced, and prescribed in fixed-dose formats.

Compounded semaglutide is different. It’s not made in bulk by pharmaceutical companies. Instead, it’s created in small batches by licensed compounding pharmacies to meet individual medical needs, or when supply of brand-name versions are in a national shortage.

It’s often used when a patient needs a more personalized option — such as starting at a lower dose, adjusting based on symptoms, or avoiding certain ingredients. Some women also explore compounded semaglutide if they’ve had side effects on a brand-name version or if they need a specific format like oral tablets.

And yes, for many, the lower cost is a bonus — but the primary reason for compounding is always medical, unless there's a national shortage declared by the FDA.

For a more in-depth look at the difference, read our brand-name GLP-1 vs compounded GLP-1 article.

Let’s break it down further.

What Does Compounded Mean?

Compounded GLP-1 medications are custom-made for an individual patient, based on a provider’s prescription.

They’re prepared in licensed U.S. pharmacies and offer flexibility that brand-name medications can’t always provide — especially for women whose bodies are more sensitive to dosing or ingredients.

That means:

• Your provider can start you at a gentler dose
• Adjustments can be made based on how your body responds
• The medication is created for your needs — not a one-size-fits-all protocol

This can be especially helpful during perimenopause or postmenopause, when symptoms and metabolism shift rapidly and require a more tailored approach.

Is Compounded Semaglutide FDA-Approved?

The short answer: No, the compounded version itself is not FDA-approved.

But here’s what matters:

• The active ingredient, semaglutide, is FDA-approved
• The compounding process is legal and regulated
• These medications are prescribed when there is a medical reason to compound — such as the need for dose flexibility or an alternate delivery format

At Josie, all compounded prescriptions are reviewed by a licensed provider and filled by U.S.-based 503(A) compounding pharmacies that meet strict quality standards.

It’s not brand-name, but it is personalized, carefully prepared, and backed by real support.

Why Midlife Women Often Do Better on Compounded Semaglutide

Women in midlife aren’t just dealing with weight gain. They’re also managing changing hormones, shifting energy levels, and a metabolism that doesn’t respond the way it used to.

That’s why a one-size-fits-all plan doesn’t always work.

Compounded semaglutide gives your provider more flexibility to match the dose and pace to what your body actually needs — especially if you’re in perimenopause or postmenopause, or dealing with insulin resistance, fatigue, or sensitivity to medications.

Let’s look at why this personalized approach makes a difference.

How Does Dose Flexibility Help in Menopause?

Hormones affect everything — appetite, digestion, blood sugar, energy, and more. And during menopause, those systems can feel completely out of sync.

A flexible dose gives your body room to adjust.

• Starting low helps reduce side effects like nausea or fatigue
• Going slow supports steadier blood sugar and energy
• Your provider can make changes based on symptoms, not strict rules

This kind of gentle approach works better with midlife metabolism, which often needs more time and support.

What Makes Josie’s Approach Different?

At Josie, the focus isn’t just on getting results fast. It’s on building something that works for your life — and your hormones — long term. For women 35+ (perimenopause through postmenopause).

• Your provider recommends a dose based on your symptoms, not a preset chart
• You’re never rushed into a higher dose just to “hurry up and lose weight”
• You also get tools that support the whole picture — like strength training workouts and high-protein meal guidance

For many women, it’s the first time a plan actually feels like it was made for them — not for someone 20 years younger with a totally different body.

What Are the Side Effects? and Can Compounded Options Help?

Like any medication, semaglutide can come with side effects. But for many women in midlife, starting low and going slow makes a big difference in how the body responds.

That’s one of the biggest benefits of compounded options — your provider can begin with a gentler dose that matches your symptoms, then gradually increase if and when your body is ready.

Let’s walk through what you might expect.

What Are the Most Common Side Effects?

Most GLP-1 side effects for menopause women show up in the first few weeks as your body adjusts to the medication. They’re usually mild and temporary — and for many women, they fade as the dose stabilizes.

The most common ones include:

• Nausea or queasiness after eating
• Fatigue, especially in the afternoon
• Constipation or slowed digestion
• Bloating or occasional headaches
• Appetite changes that feel surprising at first

Every woman is different, but if side effects show up, they’re often a sign that your body is responding and just needs time.

How Do Lower Doses Reduce Side Effects?

One of the key advantages of compounded semaglutide is dose flexibility.

Instead of jumping into a fixed dose, your provider can start with as little as 0.1 mg per week — far below the starting point of most brand-name versions, which often begin at 0.25 mg or higher.

Starting slow helps:

• Reduce nausea and GI discomfort
• Prevent fatigue or appetite swings
• Support smoother digestion and energy

At Josie, your provider monitors how you’re feeling and adjusts the dose based on what your body actually needs — not just what a chart says.

What About More Serious Side Effects?

Serious side effects are rare, but it’s important to be aware of them and speak with your provider if anything feels off.

These may include:

• Persistent vomiting or severe nausea
• Signs of dehydration (dizziness, dry mouth, low energy)
• Pancreatitis symptoms (sharp abdominal pain)
• Allergic reactions (rash, swelling, trouble breathing — very rare)

At Josie, every prescription comes with provider oversight. You’re not just handed medication and left on your own. If something doesn’t feel right, you’ll have a care team to check in with and adjust your plan.

Should I Choose Oral or Injectable Semaglutide?

If you’re considering compounded semaglutide, one of the first decisions is how to take it: oral tablets or weekly injections.

Both options use the same active ingredient, and both can support appetite control and weight loss. The difference is in how your body absorbs it, how often you take it, and what fits best with your routine, symptoms, and preferences.

Let’s break down the pros and considerations for each.

Who Might Prefer Oral?

Oral semaglutide is a great starting point for women who want to ease in — especially if you’re not comfortable with needles or you’ve had trouble with digestion in the past.

It’s also helpful if:

• You want to start slow and monitor how your body reacts
• You prefer taking something daily, like a vitamin
• You’ve had side effects on higher doses in the past
• You’re looking for the most gentle entry point into GLP-1s

At Josie, many women in perimenopause begin with oral semaglutide to test the waters. From there, they may stick with it or eventually move to injectables for longer-acting support.

Explore Josie’s compounded oral semaglutide option.

When Is Injectable a Better Fit?

Injectable semaglutide is taken just once a week, which can feel simpler for women with busy lives.

It’s often a better fit if:

• You’ve already tried oral and want stronger appetite support
• You prefer a weekly rhythm over daily pills
• You’ve used injectable medications before and feel comfortable with it
• You want more consistent levels in your system throughout the week

Injectables may offer more powerful hunger suppression for some women, especially during menopause when hormonal shifts can spike cravings or disrupt digestion.

And yes — at Josie, your provider helps you decide which format is best based on your health, symptoms, and lifestyle.

Learn more about our compounded personalized GLP-1 injectable.

Meet Michelle, 56, Who Takes Compounded Semaglutide With Josie

What does this actually look like in real life?

Michelle, 56, had tried everything — low-carb, intermittent fasting, cutting sugar. But once menopause hit, her body stopped responding. The scale crept up, her cravings got louder, and nothing seemed to stick.

That’s when she found Josie.

Michelle started with oral compounded semaglutide, not because she was afraid of injections, but because she wanted to ease in. Her provider recommended starting low and adjusting slowly based on how her body responded.

In the first six weeks, she lost 7 pounds. But more importantly:

• Her cravings dropped
• She wasn’t constantly thinking about food
• She had more energy and fewer crashes in the afternoon

After two months, Michelle felt ready to switch to the injectable version for stronger, longer-lasting support — and her provider guided her through the transition.

She says the slow start made all the difference.

“It gave me time to build better habits and actually trust my body again,” she told us. “I didn’t feel rushed or pressured. I felt supported.”

Today, Michelle is still going strong — and for the first time in years, she feels like her progress is sticking.

Is Compounded Semaglutide Right for You?

Compounded semaglutide isn’t for everyone — but it’s often a great option for women in midlife who feel like their bodies just aren’t responding the way they used to.

Many women also appreciate that compounded medications can be more affordable than brand-name versions — but the real value is in the personalization.

You might be a good fit if:

• You’re over 35 and dealing with weight gain, food noise, or low energy, thanks to fluctuating hormones
• You’ve tried diets, exercise plans, and “clean eating” with little success
• You’re looking for a more gentle, personalized approach — not a one-size-fits-all solution
• You want guidance, not just a prescription — including help with strength training, high-protein meals, and staying consistent

At Josie, we believe real progress comes from meeting your body where it is — and supporting it with the right tools, at the right pace.

If that sounds like what you’ve been missing, take our quiz and see if you qualify!

Helpful links:

• Interested in compounded oral semaglutide dissolvable tablets? Learn more here.
• Thinking about going with the compounded semaglutide injection? Get more info here.
• Take The Josie Quiz
• Learn about compounded tirzepatide for women 35+
• Compare and contrast compounded semaglutide vs compounded tirzepatide for midlife women.

FAQs About Compounded Semaglutide

Is compounded semaglutide FDA-approved?

No, compounded versions themselves are not FDA-approved. However, the active ingredient — semaglutide — is FDA-approved. Compounded medications are legally prepared by licensed U.S. pharmacies for patients with specific medical needs.

Will I qualify for compounded semaglutide at Josie?

You may qualify if you have a BMI over 30, or over 27 with weight-related symptoms like fatigue, cravings, or insulin resistance. Every application is reviewed by a licensed provider to determine if it’s a safe fit for your body.

How long will I stay on compounded semaglutide?

Most women stay on for 6 to 18 months, depending on their goals, symptoms, and how their body responds. Some continue longer with ongoing provider support, while others taper when habits are strong and weight is stable.

Is it safe to use during perimenopause or postmenopause?

Yes — many women in their 40s, 50s, and beyond find compounded semaglutide especially helpful during hormonal shifts. Josie’s providers tailor dosing to fit your symptoms, stage of life, and goals.

What if I don’t want to take injections?

That’s totally okay. Josie offers compounded oral semaglutide — a once-daily tablet option that’s great for needle-averse women or anyone wanting to start gently.

Can I switch from oral to injectable (or vice versa)?

Yes. Many women start with oral semaglutide and later transition to injectables for longer-acting support. Your provider will help you decide what works best for your body and preferences.