Weight-loss medications could impact sexual health in unexpected ways

Popular weight-loss medications may also affect aspects of sexual health, recent research has shown.

In obese and overweight men, GLP-1 (glucagon-like peptide-1) drugs increased total testosterone, optimized hormone levels and improved erectile-function scores, according to a 2025 review published by the National Institutes of Health.

Additional reviews found the same improvement in erectile dysfunction.

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Not all results have been positive, however. A study of women, published in Sage Journals in June, found that the drug’s impact on hormones could decrease sexual drive.

In a nationally representative survey led by the Kinsey Institute at Indiana University, about 52% of GLP-1 users reported that the medication had impacted their sex lives, both positively and negatively.

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Eighteen percent said their sexual desire increased, while 16% said it decreased. Another 16% noted that their sexual function improved and 14% noted it did not.

Sixteen percent also reported feeling more comfortable with their bodies, while 14% said they were less comfortable.

Dr. Peter Balazs, a hormone and weight-loss specialist in New York and New Jersey, said it’s difficult to determine whether improved sexual function is an effect of the medication or a benefit of improved self-perception after weight loss.

These outcomes also depend "heavily" on patient characteristics, the expert added.

"Individuals with severe obesity often experience meaningful hormonal improvements, whereas those with long-standing diabetic neuropathy may have irreversible neurovascular damage," he told Fox News Digital.

"Critically, when dysfunction is driven primarily by psychosocial factors, such as relationship distress, pharmacotherapy (medication) alone is unlikely to succeed."

In his own practice, Balazs reported seeing "both ends," although most of his patients have improved sex lives.

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Men under 30 were more likely to report decreased libido, which he attributed to the drug’s effects on the central nervous system rather than underlying health conditions, since younger men typically have fewer comorbidities.

GLP-1s can directly contribute to improved sexual function by improving vascular endothelial function — the inner lining of blood vessels — thereby supporting better blood flow, according to Balazs.

This function is important for cardiovascular health and, in men, can improve erectile function. In women, it can also increase pelvic blood flow, according to the expert.

Substantial weight loss reduces the function that converts testosterone to estrogen, which can help restore testosterone levels. This can improve libido, energy and overall sexual function, according to Balazs.

GLP-1s can also reduce inflammation in the brain, potentially improving peripheral nerve function, which is essential for physical sensation.

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Severe obesity can also present physical barriers during intimacy, as weight loss improves mobility and comfort.

Balazs also mentioned the psychological burden of obesity and diabetes, noting that weight-loss therapies can alleviate depression and anxiety, conditions that often contribute to sexual dysfunction.

"Improvements in physical health, body composition and self-image may indirectly reduce depression and anxiety, supporting sexual well-being," he said.

On the other hand, reduced sexual function while taking a GLP-1 drug could occur due to reward signaling in the brain, according to Balazs.

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"The [central reward] pathway contributes to pleasure associated with both food and sexual activity," he said. "Its modulation may reduce sexual desire in some patients."

"Common adverse effects, such as nausea, fatigue or malaise, as well as psychological adjustment to rapid weight loss, can indirectly decrease sexual desire."