GLP-1 and Weight Loss Drugs: Effects on Sexual Function in Men and Women | Research

The takeaway

GLP-1 drugs improve erectile function and testosterone in men, while evidence in women is limited. Tirzepatide achieves unprecedented weight loss but may have sexual side effects.

Gender gap in evidence
GLP-1 drugs show clear sexual benefits in men but direct evidence in women remains almost nonexistent

What the researchers found

GLP-1 RAs improve erectile function, testosterone, and sperm parameters in men. Tirzepatide case reports suggest potential sexual side effects. Setmelanotide demonstrates melanocortin pathway involvement in sexual function. Sexual outcomes are underrepresented as trial endpoints.

Why it matters

Sexual dysfunction affects quality of life as much as many chronic diseases. Understanding how weight loss drugs affect sexual health helps clinicians counsel patients and design better trials.

How the study worked

Narrative review of PubMed, Scopus, and Embase for studies reporting sexual outcomes (FSFI, IIEF, or clinical reports) related to obesity pharmacotherapies.

What this study cannot tell us

Most evidence is secondary outcomes or case reports. Sex-specific data extremely limited for women. Cannot distinguish direct drug effects from weight loss effects. Validated sexual function measures rarely used.

How to read the evidence

Narrative review of mostly secondary outcomes and case reports. Important gap identification but evidence quality is low throughout.

When this study was published

Published in 2025.

The bigger picture

This highlights a significant gap in clinical trial design: the most widely prescribed drugs for obesity rarely measure sexual function as a primary outcome.

Questions still open

Should future GLP-1 trials include validated sexual function measures as primary endpoints?
What is the mechanism of tirzepatide's potential sexual side effects?
How do GLP-1 drug effects on sexual function compare between men and women?

Common questions

Do GLP-1 drugs affect sexual function?

In men, the evidence is positive: GLP-1 drugs improve erectile function, testosterone, and sperm quality. In women, there isn't enough data to draw conclusions. Tirzepatide may have sexual side effects in some patients.

Why isn't sexual function routinely measured in weight loss drug trials?

It's typically only measured as a secondary outcome if at all. This review calls for validated sexual function questionnaires to be included as primary endpoints in future obesity drug trials.

Read the original research

Beyond metabolism: sexual dysfunction and weight-loss drugs.

Sexual medicine reviews, 14(1)

View on PubMed ↗Publisher’s paper ↗

Citation

Fuentes-Mendoza, Jenyfer M; Concepción-Zavaleta, Marcio J; Mendoza-Godoy, Jeny J; Concepción-Urteaga, Luis; Paz-Ibarra, José; Coronado-Arroyo, Julia C. (2026). Beyond metabolism: sexual dysfunction and weight-loss drugs.. Sexual medicine reviews, 14(1). https://doi.org/10.1093/sxmrev/qeaf074