Weight-loss medications could impact sexual health in unexpected ways

GLP-1 drugs can help to boost sexual function and libido, according to patients and recent research.(iStock)

In a nationally representative survey led by the Kinsey Institute at Indiana University, about 52% of GLP-1 users reported thatthe medicationhad 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.

Results vary

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.

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“Individuals withsevere obesityoften experience meaningful hormonal improvements, whereas those with long-standing diabetic neuropathy may have irreversible neurovascular damage,�

“Critically, when dysfunction is driven primarily by psychosocial factors, such asrelationship distress, pharmacotherapy (medication) alone is unlikely to succeed.”

Patients have reported improved sexual function and desire, as well as feeling more comfortable with their bodies.(iStock)

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

health conditions, since younger men typically have fewer comorbidities.

Reasons for changes

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 improveerectile function.In women, it can also increase pelvic blood flow, according to the expert.

GLP-1s can impact blood flow and neurological pathways, which both relate to sexual function, experts say.(iStock)

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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 improvingperipheral nerve function, which is essential for physical sensation.

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

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

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

“Improvements inphysical 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 aspsychological adjustmentto rapid weight loss, can indirectly decrease sexual desire.”

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