What Effects do GLP-1 Agonists Have on Sexual Health?

GLP-1 medications have become widely discussed in recent years. It may feel like every time you turn on your favorite show on streaming, there are a thousand ads about the next semaglutide or another injection or pill available for weight loss. But what is a GLP-1, and how could it affect your sexual health?

GLP-1 agonists were originally approved by the U.S. Food and Drug Administration (FDA) in 2005 as a treatment for type 2 diabetes, and later, other versions were introduced for weight loss in medically obese individuals.

GLP-1 is a naturally occurring hormone found in the small intestine that works to release insulin from the pancreas. The insulin is then able to control how the body uses food for energy, which in turn helps reduce blood sugar. GLP-1 agonists act like this hormone, helping to control blood sugar levels. They can also slow stomach emptying and affect satiety signals in the brain, leaving people feeling fuller for longer.

Because these medications are now increasingly prescribed for weight loss, there is limited information on the effects this particular use may have on sexual health. However, recent evidence has suggested that low sexual desire and absent orgasm (anorgasmia) are key negatives to keep an eye on.

Negative Effects May Happen Right Away

GLP-1 agonists have been said to reduce desire for more than just food. Some patients have stated they’ve been able to lessen their use of marijuana, nicotine, alcohol, opiates, and more. In addition, several patients have reported their loss of sexual desire (libido) while on GLP-1 agonists. This may have to do with its interaction with other hormones, such as serotonin (known popularly as the happy hormone), which is a neurotransmitter involved in mood and appetite regulation, and sex hormone-binding globulin (SHBG).

Serotonin helps regulate mood, appetite, and sleep, amongst others. So, overactivation to curb appetite may result in insomnia, overall agitation, and sexual dysfunction. This is also seen in medications for depression (SSRIs), which increase serotonin to help regulate mood and are known to cause low libido and delayed/anorgasmia as well. SHBG may increase during obesity treatment. This can reduce the level of free circulating hormones in the body, which usually means lower libido.

Positive Effects Experienced Over Time

In contrast, GLP-1 agonists may also help increase libido through other pathways. Testosterone – specifically in women – tends to surge during ovulation, which ideally should increase libido. However, fat tissues tend to store and metabolize natural estrogen. This may lead to a negative feedback loop in which obese women do not experience high spikes of testosterone. Additionally, obesity can cause lower testosterone levels in men, causing a similar negative feedback loop and decreasing libido. Some researchers believe the effects of losing weight through GLP-1 agonists may help with the regulation of these sex hormones in those who are clinically obese.

Loss of weight from GLP-1 agonists may also help with psychological hindrances to libido, like low self-esteem from previous stigmatization. It may additionally help with genital blood flow, which can improve issues like erectile dysfunction or anorgasmia.

Key Takeaways

• GLP-1 agonists are intended and approved to help with blood sugar regulation in type 2 diabetes patients, and in certain cases for clinical obesity, when no other methods have worked.
• There is currently not enough research on the sexual health effects of these medications to draw complete conclusions.
  • Because GLP-1 agonists have many different pathways in the body they work through, sexual health effects may be different in different people.
  • Some may see no change at all – whether positive or negative.
• GLP-1 agonists may initially reduce sexual desire, or the ability to orgasm.
• Over time and with successful use, GLP-1 agonists may lead to improved libido and sexual function.
• It may be beneficial to speak with a healthcare provider if you are experiencing weight- or weight loss-related sexual health issues.

Resources:

Collins L, Costello RA. Glucagon-Like Peptide-1 Receptor Agonists. [Updated 2024 Feb 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551568/

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Lengsfeld, S., Hasenbohler, F., Probst, L., Baur, F., Emara, Y., Bathelt, C., Werlen, L., Vogt, D., Caviezel, B., Vukajlovic, T., Christ-Crain, M., & Winzeler, B. (2023). Effects of glucagon-like peptide-1 analogs on sexual desire: A randomized, double-blind, placebo-controlled crossover trial. Endocrine Abstracts, 90, 96. https://doi.org/10.1530/endoabs.90.p69

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