In recent years, GLP‑1 receptor agonists (GLP‑1 RAs) like semaglutide (Ozempic, Wegovy) and tirzepatide (Zepbound) have reshaped the treatment of type 2 diabetes and obesity. Originally developed to regulate blood sugar, these drugs have since become emblematic of a broader shift toward metabolic medicine, weight loss pharmacotherapy, and lifestyle intervention via pharmacologic means. But as usage has surged, so too have reports of unexpected side effects, including changes in sexual desire, performance, and intimacy.
Some users describe renewed libido and better sex lives, attributing improvements to weight loss, increased energy, and restored confidence. Others report the opposite: loss of libido, sexual numbness, and even emotional detachment. Media outlets, Reddit threads, and clinical reports present a puzzling dichotomy that neither pharmaceutical labels nor traditional adverse event monitoring have fully resolved.
This article explores the conflicting signals around GLP‑1 medications and sex drawing on emerging pharmacovigilance data, mechanistic theories, patient experiences, and clinical trials. The goal is to clarify what we know (and don’t), highlight sex-specific considerations, and offer guidance for clinicians and patients navigating the evolving sexual side effect profile of this powerful new class of drugs.
This article explores the conflicting signals around GLP‑1 medications and sex drawing on emerging pharmacovigilance data, mechanistic theories, patient experiences, and clinical trials.
Epidemiology & Preclinical Insights
Although GLP‑1 receptor agonists were not designed with sexual function in mind, research is beginning to probe how they interact with the body’s neuroendocrine and vascular systems, both of which influence libido and performance. Yet, robust epidemiologic data remain scarce. A recent Nature correspondence (2025) analyzed reports submitted to the U.S. Food and Drug Administration’s Adverse Event Reporting System (FAERS), highlighting a signal for male sexual dysfunction in users of semaglutide and liraglutide. Though limited by underreporting and lack of causality, this pharmacovigilance signal has raised concerns, especially as prescriptions surge globally (Nature, 2025).
Conversely, some small-scale studies and registry data suggest sexual function may improve in people with type 2 diabetes taking GLP‑1 RAs. One study published in Andrology found that men on liraglutide or dulaglutide showed improvements in erectile function scores, particularly when weight loss and glycemic control were achieved (Lisco et al., 2024).
Animal models offer partial explanations. Rodent studies have shown that GLP‑1 analogues can reduce dopaminergic signaling in mesolimbic pathways areas involved in reward, including sexual reward. This has led to hypotheses that these drugs may blunt overall reward sensitivity, which might suppress sexual interest or pleasure in some users (Arillotta et al., 2024).
Still, there are gaps in population-level data. Large randomized controlled trials (RCTs) have not prospectively measured sexual desire or satisfaction as primary outcomes. Without structured instruments like the International Index of Erectile Function (IIEF) or Female Sexual Function Index (FSFI), clinicians and patients are left to rely on indirect, observational clues. Understanding these early insights is essential, especially as clinicians attempt to distinguish between primary pharmacologic effects and secondary outcomes linked to weight loss or improved metabolic health.
User Experience: Anecdotes and Media Reports
Outside of trials and registries, a very different type of dataset has emerged – the lived experience of GLP-1 users, shared via social media, blogs, and press interviews. These narratives reveal a striking duality in sexual outcomes, often tied not just to biology, but to identity, body image, and emotional change. In a widely circulated WIRED feature, journalist Amanda Hoover profiles individuals like Shane Desmond, a 37-year-old who credits Wegovy with restoring his libido after years of obesity-related fatigue and low self-esteem. “I feel alive again,” he says, describing a new sense of confidence and intimacy with his partner after shedding 40 pounds (Hoover, 2025).
However, not all stories are as affirming. People Magazine and The Times have documented cases of blunted sexual desire, muted orgasms, and relationship strain linked to GLP-1 drugs. Some users report feeling emotionally “flat,” even disinterested in sex despite improvements in body weight or energy levels. A Reddit thread titled “Ozempic killed my libido” has accumulated thousands of comments echoing similar experiences.
Cultural observers have picked up on the broader implications. The Kinsey Institute reported early data from 2024 suggesting that rapid weight loss from GLP-1 use may disrupt not just body image, but relational roles and expectations, especially in couples with preexisting sexual dysfunction or mismatched libido.
Some users feel empowered by their transformation. Others feel disconnected, dysphoric, or chemically “different.”
While anecdotal, these accounts matter. They point to a reality that’s more nuanced than clinical averages can capture. They also underscore a key question: Are changes in libido a direct pharmacological effect, or a byproduct of rapid physiological and psychological change?
These narratives reveal a striking duality in sexual outcomes, often tied not just to biology, but to identity, body image, and emotional change.
Clinical and Pharmacovigilance Data
While anecdotal reports provide compelling insight, clinicians need structured data to make informed decisions. So far, evidence from clinical trials and pharmacovigilance systems paints a conflicted picture, suggesting possible risk, but with many caveats.
In 2025, a Nature correspondence drew attention to spontaneous reports of male sexual dysfunction in users of GLP-1 receptor agonists, primarily semaglutide and liraglutide, as recorded in the FDA’s FAERS database (Nature, 2025). The authors noted a disproportionate number of cases involving reduced libido, erectile dysfunction, and ejaculation issues. However, FAERS data are inherently limited: underreporting is common, and confounding variables, such as weight, comorbidities, or concurrent medications, are rarely accounted for.
Contrastingly, a prospective study published in Andrology followed diabetic men starting GLP-1 therapy and found statistically significant improvements in erectile function scores and overall satisfaction over a 12-week period (Lisco et al., 2024). The improvements correlated strongly with weight loss and HbA1c reduction, suggesting that indirect metabolic benefits may outweigh any potential negative effect. Further complicating interpretation are sex differences and dosing variations. A 2022 study in Journal of Personalized Medicine noted that men and women may respond differently to GLP-1 RAs in terms of emotional reactivity and reward behaviors (Arillotta et al., 2024). These psychosocial dimensions can blur the line between pharmacological effect and psychological adjustment.
To date, no large randomized controlled trial has included sexual function as a pre-specified endpoint in GLP-1 studies. Without that, clinicians must extrapolate from adjacent outcomes like energy, mood, self-esteem, and metabolic markers.
The result is clinical ambiguity: data suggest both benefit and risk, often mediated by the patient’s baseline health, sex, and expectations.
Mechanistic Hypotheses & Clinical Implications
So why do some people on GLP‑1 receptor agonists feel revitalized sexually, while others feel numb? The answer likely lies in neurochemical complexity and the drug class’s far-reaching influence on the brain’s reward and motivation systems. One leading theory is that GLP‑1 agonists, especially semaglutide, may dampen dopaminergic signaling in the mesolimbic pathway, an area central to food reward, sex drive, and addictive behavior. As reported in People, some users say the drug doesn’t just make them disinterested in food or alcohol it makes them “feel less,” emotionally and physically. This blunted reward sensitivity could extend to libido in some individuals, particularly those who already struggle with low baseline desire (Arillotta et al., 2024).
At the same time, the secondary benefits of weight loss improved cardiovascular health, better mobility, increased energy, and a more positive body image can significantly enhance sexual function. This is particularly true in patients with obesity-related erectile dysfunction or fatigue-related sexual avoidance.
Clinically, this means providers should approach sexual side effects not as binary outcomes, but as part of a larger biopsychosocial equation. Routine sexual health screening should be included in follow-ups for GLP‑1 therapy. If a patient reports diminished libido, clinicians should explore whether it’s related to psychological adjustment, medication effect, or other underlying factors.
Importantly, many users reporting sexual side effects see improvement over time or with dose adjustments, indicating that the phenomenon may be reversible, dynamic, and patient-specific.
References
- Arillotta, D., De Luca, I., Rossi, R., & Ferri, F. (2024). GLP-1 receptor agonists and reward processing: A neurobehavioral hypothesis on diminished desire. Journal of Personalized Medicine, 12(3), 454. https://doi.org/10.3390/jpm12030454
- Hoover, A. (2025, February 12). Your love life on Ozempic. WIRED. https://www.wired.com/story/ozempic-glp-1s-libido-love-life/
- Lisco, G., Stanca, L., De Giorgi, A., D’Amuri, A., Giagulli, V. A., & Triggiani, V. (2024). Long-acting GLP‑1 receptor agonists improve erectile function in men with type 2 diabetes: Results from a prospective observational study. Andrology, 12(3), 633–642. https://doi.org/10.1111/andr.13519
- Nature Correspondence. (2025). Comment on male sexual dysfunction associated with GLP-1 RAs in pharmacovigilance data. International Journal of Impotence Research. https://doi.org/10.1038/s41443-025-01155-x
- People. (2024, July 10). Ozempic can ‘potentially’ change your personality and sex life, expert says. People Magazine. https://people.com/ozempic-changes-personality-sex-life-alcohol-glp1-8636962
- The Times. (2024, August 2). Could Ozempic have killed my libido? The Times (UK). https://www.thetimes.co.uk/article/could-ozempic-have-killed-my-libido-j7ghmt6s6
- The Sun. (2024, August 3). Fat jabs are reshaping sex and dating for Gen Z. The Sun. https://www.thesun.co.uk/health/35872831/fat-jabs-sex-reshaping-dating-scene/
