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An increased secretion of GLP-1 may be responsible for postprandial reactive hypoglycemia, whereas a decreased secretion of GLP-1 may be responsible for obesity

That said, there are biologically plausible indirect pathways by which semaglutide treatmentespecially when accompanied by rapid appetite suppression, gastrointestinal adverse effects, and clinically meaningful weight losscould unmask or exacerbate pre-existing vaginal symptoms (for example, genitourinary syndrome of menopause) or contribute to discomfort through dehydration, altered sex steroid milieu, or pelvic soft-tissue volume changes

That reason could be adjusting the dose or tailoring the medication to a specific patient

doi:10.1053/j.gastro.2007.03.054 Adams TD, Davidson LE, Litwin SE, et al