GLP-1 Medications and Their Impact on Sexual Health

JOSH*, 35, found himself able to go weeks or even months without sex. However, that all changed when he began taking Mounjaro two years ago. In just a few months, he lost 11 pounds and noticed a significant increase in both libido and erections, feeling more like a teenager again.

On the other hand, David*, 75, had a different story. Shortly after starting Wegovy, he experienced a decline in sexual desire and struggled with orgasms.

These fluctuations were temporary and seemed to diminish as both men continued with their GLP-1 treatments. Still, their experiences highlight crucial questions that researchers are seeking to answer as the interest in these medications rises.

A 2025 Kinsey Institute survey revealed that over half of those taking GLP-1 drugs noted changes in their sex lives; however, these changes were mixed. Sixteen percent reported a decrease in desire, while eighteen percent experienced an increase. Moreover, sixteen percent felt their sexual function improved, but twelve percent noted it got worse. Interestingly, men were about twice as likely as women to report these variations, whether positive or negative.

With GLP-1 usage in the U.S. quadrupling since 2024, it’s worthwhile to consider whether these sexual changes stem from the medications themselves or from the physical and psychological impacts that accompany treatment.

The Research on GLP-1 Meds and Sexual Health

It’s essential to understand that clinical evidence in this area is still limited—and what research exists doesn’t provide clear answers.

In one 2025 observational study, users of semaglutide were more likely to receive diagnoses or prescriptions for erectile dysfunction. But this observation implies correlation rather than causation.

Other studies indicated that taking dulaglutide for four weeks had no effect on sexual desire, and long-term use was linked to a slightly lower risk of moderate to severe erectile dysfunction. However, the first study was based on a small sample size, and the second had funding ties to Eli Lilly, raising potential conflicts of interest.

Thus, there’s a pressing need for larger, unbiased studies. “No research so far conclusively shows that GLP-1 RA medications cause changes in sexual desire or erectile dysfunction,” said Marsha Novick, MD, a family medicine and obesity medicine specialist.

According to Jay Luthar, MD, a Harvard-trained internist, while liraglutide, semaglutide, and tirzepatide are often categorized together, they aren’t identical, so findings about one shouldn’t be assumed for the others.

“Isolating drug effects from weight loss, metabolic shifts, nausea, fatigue, mood changes, and pre-existing dysfunction is a challenging task, and so far, studies designed for this are lacking,” says Evan Appelbaum, MD, a cardiologist.

Why GLP-1s Might Increase Your Sex Drive

WE KNOW THAT obesity and metabolic issues can contribute to low testosterone and erectile problems, and GLP-1s may elevate testosterone. Thus, it makes sense that as individuals lose weight, their sexual desire may increase. Dr. Appelbaum notes that weight loss can also enhance vascular health, which is crucial for erections.

However, several mechanisms might be in play, according to Dr. Luthar. Beyond metabolic and hormonal shifts, losing weight can boost energy and self-esteem—factors that might lead to a greater willingness to engage in sexual activity.

“These psychological aspects are significant—desire isn’t just physical; it encompasses how a man perceives himself,” Dr. Appelbaum emphasizes.

Take the case of Christopher*, 44, who, when starting Mounjaro three years ago, had a low libido. As he shed pounds and saw physical changes, his confidence surged, prompting him to work out and explore romantic relationships. He even felt that as he lost weight, his penis appeared larger. By six weeks into treatment, his libido noticeably increased, which continued to rise over three months.

Overall, Dr. Luthar believes most men with obesity on GLP-1s likely see improvements in sexual health, but he acknowledges some encounter negative effects—researchers still don’t fully understand how prevalent these adverse effects are or their underlying causes.

Why GLP-1s Might Decrease Your Sex Drive

NAUSEA, FATIGUE, HEADACHES, indigestion, and diarrhea are among the common side effects of GLP-1s, which may explain why some men experience a drop in sexual desire.

Dr. Luthar suggests, “The more straightforward explanation is likely the more common one. If someone feels nauseous, tired, and is eating very little due to rapid weight loss, they certainly won’t feel very sexy.”

Another angle suggests that GLP-1 medications induce weight loss by suppressing appetite—which, as Dr. Luthar notes, might also dampen sexual interest.

Research in animal studies indicates these medications could alter reward-driven behaviors, but as Dr. Luthar cautions, it’s unclear how this might affect human sexual desire.

“The conditions under which these studies are conducted often differ from how people use these drugs, and, well, you can’t just ask mice about their libido,” he quips.

Matthew Miller, 37, a nurse practitioner, observed a significant decrease in his sex drive four weeks after starting tirzepatide and six weeks after starting semaglutide. He described the experience as akin to anhedonia—loss of pleasure in activities previously enjoyed. Thankfully, his libido normalized upon reaching a stable maintenance dose.

Why Your Erections and Sex Drive Might Move in Opposite Directions

FIRST, THERE’S A vital distinction between libido, erectile function, and orgasm.

“Desire and erections are interrelated yet distinct,” says Dr. Luthar. “Desire primarily resides in the brain and relates to motivation, hormones, mood, energy, and relationship dynamics. In contrast, erections depend on physiological factors—the state of blood vessels and nerves, with the brain signaling readiness.”

This means it’s entirely possible to experience improved erectile function as vascular health enhances while feeling less inclined towards sexual activity due to fatigue or emotional flatness.

For example, Dr. Appelbaum mentions treating two men who both lost around 40 pounds—one experienced heightened desire and strong erections, while the other did not notice any increase in desire, despite normal erectile function and stable testosterone levels.

Orgasm complicates the picture further. A 2025 analysis of FDA adverse-event reports included complaints related to orgasm, though researchers remain unable to confirm whether medications caused these issues.

“Some men undergoing GLP-1 therapy report a dulling of orgasmic satisfaction—they can achieve orgasm, but it feels less gratifying,” Dr. Appelbaum notes. “Others mention delayed or strenuous orgasms.”

Will the Changes Last—and What Can You Do About Them?

FOR SOME OF the men we talked to, sexual issues seemed to improve as other side effects faded. However, experts concur that any concerning changes—especially if they negatively impact mood or relationships—should be discussed with a healthcare provider. Share when symptoms appeared and whether they intensified with dosage increases.

Dr. Luthar adds that mood and sleep alterations should also be examined, as they can significantly influence sexual desire. Your doctor may conduct hormone tests as well since new erectile challenges could signal low testosterone or cardiovascular concerns.

“It’s vital to exclude other issues like thyroid dysfunction, alcohol use, stress, and relational conflicts,” he emphasizes.

On a positive note, simple solutions exist that don’t require halting medication use—like moderating dose increases, identifying nutrient deficiencies, or addressing low testosterone.

“I’ve seen patients in this situation improve by reducing their dosage,” Dr. Appelbaum comments. “For others, we’ve had to weigh the metabolic advantages of continuing treatment against the downsides to quality of life due to reduced libido.”

Above all, don’t dismiss any issues related to erectile function or climax; they deserve attention.

“Your sexual health is integral to your overall well-being,” Dr. Appelbaum concludes. “Your doctor should be aware.”

*Names have been changed to protect sources’ privacy.