First approved in 2021, new weight loss drugs, “GLP-1 receptor agonists,” include several drugs, most notably semaglutide (Wegovy, Ozempic). GLP-1s are suppressed appetite so good that they are the most effective weight loss pills ever developed. They also lower blood sugar, which helps in the treatment of diabetes.
In 2026, just five years after GLP-1 was first approved, an estimated 12 percent of American adults, or one in eight, are now taking them. Many report losing 20 to 40 pounds, sometimes more, and hail GLP-1 as a miracle.
Many users also report improved sex. This makes biological sense, especially for diabetics. Diabetes damages the blood vessels, including the blood vessels that carry blood through the genitals. Diabetes is known to cause sexual dysfunction, especially erectile dysfunction (ED). GLP-1 regulates blood flow. Since blood flows more freely through the genitals, the erection becomes stronger.
In addition, carrying extra weight requires a lot of energy. When the drug reduces weight, most users report less fatigue and more energy for pleasurable activities, including sex.
However, few reports have also linked GLP-1 with various sexual complaints. The supplements that come with the drugs mention potential sexual side effects, possibly because some were discovered during the approval process. But research on all this is still in its infancy.
So far, it appears that only a small percentage of GLP-1 users develop sexual problems. But all involved – users and sexuality and mental health professionals who deal with them should be aware that GLP-1 can cause sex-enhancing effects.
Recent research on the sexual effects of the drug GLP-1
Here is a summary of the latest research:
- Loss of libido. We expect weight loss through GLP-1 to increase sexual desire. People who shed pounds feel more energetic. They feel better and say they are better. Add them up, and many GLP-1 users report a greater interest in sex.
But there are also scattered reports of loss of libido in some GLP-1 users. Researchers at George Washington University speculate that this is related to changes in serotonin, a neurotransmitter involved in mood regulation, including erotic feelings. The famous USSR antidepressants (Prozac et al.) also affects serotonin and causes sexual arousal. In some people, GLP-1 appears to have similar actions.
- Weaker orgasm. GLP-1 weight loss mainly involves fat loss. In addition, there is some loss of muscle tissue, including the pelvic floor muscles. In all sexes, these are the muscles that contract during them orgasmprovide pleasure. If GLP-1 decreases the mass of the pelvic muscles, they may not contract as well. Orgasms may be weaker and less pleasurable. In one case report, a woman taking GLP-1 lost the ability to orgasm. Now, this is just one report among millions of users. However, users and professionals should be aware of the possibility.
- Hormonal changes. Sex hormones, estrogen and testosteroneare synthesized from cholesterol. Losing body fat can lower cholesterol levels (usually a good thing) and change blood levels of these hormones (possibly bad). If you take GLP-1 and notice changes in sex, ask your doctor to check your sex hormone levels. Estrogen ointment or testosterone supplementation may be indicated.
- The vulvar skin changes. The outer lips of the vagina (labia majora) protect the inner lips (labia minora) and the entrance to the vagina. When women use GLP-1, the labia majora loses some of its fat and may shrink, lengthen, droop, or become less prominent. As the outer labia become smaller, the inner labia may become more prominent. Now some doctors call this “ozemic vulva”. Some women have also reported lip discomfort, itching, and even sores.
- Effects of the mixture on erection. In between diabetic In men, GLP-1s improve erections. Italian researchers gave 108 diabetic men, with an average age of 60, or standard diabetes. medicine or that drug in addition to GLP-1. After one year, those taking GLP-1 reported significant relief from erectile problems (p < 0.0001).
As body fat decreases, testosterone levels in the blood decrease. Testosterone levels fluctuate throughout the day, but when men take GLP-1, testosterone can drop to the point of decreasing libido and testicular function. Another group of Italian investigators analyzed studies of the use of GLP-1 by 680 obese and diabetic men with this problem. Medicines helped. In addition to significant weight loss, participants’ testosterone levels increased and their testicular function improved (p < 0.0001).
However, among the fat non-diabetic men, that’s another story. Researchers from Johns Hopkins and the University of Texas administered GLP-1 to 3,094 obese men who did not have diabetes. Compared to similar diabetic men who did not take GLP-1, those who did were “more likely” to report erectile dysfunction. It is not clear why, but the large sample lends credence to this finding.
- Gastrointestinal (GI) problems. GLP-1 slows gastric emptying. The gut is involved in emotion, as the phrase “gut feelings” implies. Drug users may experience decreased gastric emptying as GI distress, and this can decrease libido and reduce sexual pleasure.
- Constipation. GLP-1 also slows the passage of food through the lower digestive tract. This can lead to chronic constipation, one of the nation’s most common medical problems, affecting an estimated 20 percent of American adults. Chronic constipation can reduce sexual desire and pleasure. If you take GLP-1, make sure your small meals include foods that prevent constipation: fruits, vegetables, and whole grains. Regular exercise also helps. Doctors who prescribe GLP-1 often remind users to exercise more. But as GLP-1 reduces muscle mass, users may find it harder to do so. Work to stay active. Aim for 30 to 60 minutes of exercise every day, such as walking.
GLP-1 can be lifesavers. They help control diabetes and obesity, both of which increase the risk of heart disease and stroke. But this good news should be somewhat tempered by the emerging findings that GLP-1 is not sexually harmful. GLP-1 users and professionals who advise them should understand that the drug can cause or worsen sexual problems.
As new findings become available, I will report them.
