Glucagon-like receptor-1 agonists and impotence: A meta-analysis.
GLP-1 agonists may improve erectile dysfunction and increase certain hormone levels in males, but larger studies are needed to confirm these effects.
Where it sits
this study against the rest of the dulaglutide corpusSummary and findings
This meta-analysis evaluated the effects of GLP-1 agonists, including dulaglutide, on erectile dysfunction and hormone levels in males. Seven studies with 237 male participants were analyzed. GLP-1 agonists significantly improved erectile dysfunction scores and increased total testosterone, SHBG, and FSH levels.
Abstract
<h4>Background</h4>Glucagon-like peptide receptors-1 agonists (GLP-1 agonists) have revolutionized the treatment of obesity and diabetes due to their potent effects on weight and glycemic control, and cardiorenal protection. However, emerging reports and post-marketing surveillance have raised concerns regarding erectile dysfunction (ED) or impotence in a subset of male patients.<h4>Aim</h4>To assess the association between GLP-1 agonists, ED, total (TT) and free testosterone (FT), sex hormone binding globulins (SHBG), luteinizing hormone (LH), and follicular stimulating hormone (FSH).<h4>Methods</h4>We systematically searched PubMed, Google Scholar, and Web of Science in November and December 2026 for articles examining the association between GLP-1 agonists and ED, with no publication date restriction. However, only articles published in the English language were eligible. The terms used were GLP-1 agonists, ED, semaglutide, liraglutide, ozympic, tirzepatide, dulaglutide, and Impotence.<h4>Results</h4>One hundred seventy-two articles were found; after removing duplicates, 63 remained, of which 12 full texts were screened, and 7 studies were included in the final meta-analysis. Seven studies involving 237 males were included. GLP-1 agonist therapy improved ED score with a significant statistical difference, MD = 2.73, 95% confidence interval (CI): 1.64-3.83. A significant increase was found regarding TT, SHBG, and FSH, MD 73.04, 95%CI: 16.91-129.17, MD 7.00, 95%CI: 1.71-12.30, and MD 0.46, 95%CI: 0.01-0.91 respectively.<h4>Conclusion</h4>No significant differences were evident regarding the FT, and LH. GLP-1 agonists significantly improved ED, TT, SHBG, and FSH in males, no effects were observed on FT, and LH; larger randomized trials are needed.
Background
This study addresses the concern that GLP-1 agonists, while effective for obesity and diabetes, may impact erectile function in males. Previous reports have suggested a potential link between these medications and erectile dysfunction. Understanding this association is important for clinicians prescribing GLP-1 agonists to male patients.
Methods
The meta-analysis systematically reviewed literature from PubMed, Google Scholar, and Web of Science, focusing on studies that examined the association between GLP-1 agonists and erectile dysfunction. A total of 172 articles were initially identified, with 63 remaining after duplicates were removed. Twelve full texts were screened, and seven studies involving 237 males were included in the final analysis.
Results
The meta-analysis found that GLP-1 agonist therapy significantly improved erectile dysfunction scores, with a mean difference of 2.73 and a 95% confidence interval of 1.64 to 3.83. Additionally, significant increases were observed in total testosterone (MD 73.04, 95% CI: 16.91-129.17), SHBG (MD 7.00, 95% CI: 1.71-12.30), and FSH (MD 0.46, 95% CI: 0.01-0.91). No significant changes were noted in free testosterone and luteinizing hormone levels.
Interpretation
The findings suggest that GLP-1 agonists may have a beneficial effect on erectile dysfunction and certain hormone levels in males, although the clinical significance of these changes is uncertain. The effect sizes, while statistically significant, may not translate into meaningful clinical improvements without further validation in larger trials. The small sample size and limited number of studies included are notable limitations.
Key findings
- MD = 2.73 improvement in ED score, 95% CI: 1.64-3.83
- MD 73.04 increase in TT, 95% CI: 16.91-129.17
- MD 7.00 increase in SHBG, 95% CI: 1.71-12.30
- MD 0.46 increase in FSH, 95% CI: 0.01-0.91
- No significant changes in FT and LH
Limitations
- Small sample size of 237 males
- Only seven studies included
- Larger randomized trials needed
- Potential language bias (English-only publications)