Question
Does semaglutide cause erectile dysfunction?
Answer
Ozempic is the brand name for a drug called semaglutide, which is used for treatment of type 2 diabetes. Semaglutide is also marketed as Wegovy, for treatment of obesity.
In Australia, semaglutide is approved for the treatment of diabetes and obesity, but the Pharmaceutical Benefits Scheme only subsidises diabetes treatment in specific circumstances. Semaglutide for weight loss is only available by ‘private prescription’, meaning that users pay the full cost of the medication.
Semaglutide is a type of drug called a GLP-1 receptor agonist (GLP-1RA). Other GLP-1RAs available in Australia are liraglutide, tirzepatide and dulaglutide.
GLP-1RAs work in a similar way to glucagon-like peptide-1 (a natural peptide hormone produced by cells in the intestine and in part of the brain), regulating blood sugar levels and appetite. GLP-1 was discovered in the 1980s, and GLP-1RAs have been around for about 20 years (the first one approved for humans was a synthetic version of a molecule isolated from the venom of Gila monsters), but recent development of new versions of this type of drug are revolutionising treatment of diabetes and obesity. GLP-1RAs may also be beneficial for treatment of other conditions, including arthritis, Alzheimer’s and Parkinson’s disease, cardiovascular disease, stroke, and cancer.
What impact does Ozempic have on male sexual health?
There’s no good evidence that GLP-1RAs cause erectile dysfunction (ED), despite what click-baity headlines might suggest. The best available evidence, from patients enrolled in a randomised controlled trial, suggests that dulaglutide prevents erectile dysfunction in men with diabetes and cardiovascular disease aged over 50 years. Better erectile function was also seen in men who were admitted to hospital because of complications of diabetes or prediabetes if they were taking a GLP-1RA (compared to men treated with insulin). It’s important to understand that the results of studies like these, which enrol groups of men with specific combinations of health problems, do not mean the same effects of GLP-1RAs will be seen in all men.
A recent investigation using a large patient database found that prescription of semaglutide is associated with erectile dysfunction in obese men (BMI >30) without diagnosed diabetes or sexual dysfunction, but the way the study was done raises questions about the validity of the results. To start with, the study looked only at prescription of semaglutide, not whether men actually took the drug. Also, the matching of men who had prescriptions for semaglutide, with control subjects who didn’t, wasn’t perfect (this is often a problem with studies of this type). BMI was higher in the semaglutide group, which would be expected to raise the risk of ED, and account for at least some of the difference. There may be other important but unknown differences that account for the results.
Another study, that looked at Reddit users’ comments about GLP-1RAs in 5,859 threads, didn’t mention any comments related to erectile dysfunction.
Theres no doubt that the use of GLP-1RAs is going to keep increasing. As this happens, more information will become available about the side effects of treatment, including effects on erectile function.
Tim Moss
Healthy Male Health Content Manager
Associate Professor Tim Moss has PhD in physiology and more than 20 years’ experience as a biomedical research scientist. Tim stepped away from his successful academic career at the end of 2019, to apply his skills in turning complicated scientific and medical knowledge into information that all people can use to improve their health and wellbeing. Tim has written for crikey.com and Scientific American’s Observations blog, which is far more interesting than his authorship of over 150 academic publications. He has studied science communication at the Alan Alda Centre for Communicating Science in New York, and at the Department of Biological Engineering Communication Lab at MIT in Boston.
