{
 "page": "https://jabbitapp.com/research/ozempic-wegovy-zepbound-erectile-dysfunction-libido-testosterone-teardown.html",
 "checked": "2026-10-28",
 "note": "Quotes asserted against cached copies. Chart 1: Able et al. IJIR 2024 abstract (percent of men with the outcome, semaglutide vs matched non-users). Chart 2: risk, hazard or reporting odds ratios with 95% CIs as reported in each abstract; different designs, comparators and populations, not pooled. FAERS reporting odds ratios measure reporting patterns, not risk. Label check: case-insensitive count of 'erectil', 'sexual dysfunction', 'libido', 'impoten' in the cached US label texts; all zero.",
 "pubmed_abstract_quotes": {
  "38778151": [
   "3,094 non-diabetic, obese men ages 18-50 who received a prescription of semaglutide were identified and subsequently matched to an equal number cohort of non-diabetic, obese men who never received a prescription of semaglutide.",
   "average age at index prescription for non-diabetic, obese men was 37.8 ± 7.8 and average BMI at index prescription was 38.6 ± 5.6",
   "(1.47% vs 0.32%; RR: 4.5; 95% CI [2.3, 9.0])",
   "testosterone deficiency (1.53% vs 0.80%; RR: 1.9; 95% CI [1.2, 3.1])",
   "While package inserts include sexual dysfunction as a side effect, no study has assessed the degree of this risk."
  ],
  "42005929": [
   "this study included 4910 GLP-1RA initiators and 5524 DPP4i initiators with well-balanced baseline covariates",
   "The incidence rate of ED was higher in the GLP-1RA users (35.2 vs. 28.0 per 1000 person-years) than DPP4i users, with a slightly increased rate (HR, 1.26; 95% CI, 1.08-1.46).",
   "the association was attenuated and no longer statistically significant after NCO calibration",
   "These observational findings may reflect residual or selection bias and do not establish causation."
  ],
  "34153269": [
   "3725 (70·1%) of 5312 male participants with a mean age of 65·5 years (SD 6·4 years) were analysed",
   "2104 (56·5%) had moderate or severe erectile dysfunction at baseline",
   "The incidence of erectile dysfunction following randomisation was 21·3 per 100 person-years in the dulaglutide group and 22·0 per 100 person-years in the placebo group (HR 0·92, 95% CI 0·85-0·99, p=0·021).",
   "Long-term use of dulaglutide might reduce the incidence of moderate or severe erectile dysfunction in men with type 2 diabetes.",
   "Eli Lilly and Company."
  ],
  "39232425": [
   "healthy eugonadal men of normal weight, aged 18-50 years with active and satisfactory sex lifes were (1:1) randomly allocated to dulaglutide or placebo for four weeks",
   "No change in the MGH-SFQ was observed after four weeks of dulaglutide versus placebo (estimated difference 0.58 [95% CI -0.83 to 2.00], p-value = 0.402).",
   "24 out of 26 randomised participants completed the study"
  ],
  "40614622": [
   "Male patients aged 18-70 with T2D and no prior ED were included.",
   "tirzepatide vs. sitagliptin: RR, 0.70 (95 % CI: 0.64,0.76); tirzepatide vs. injectable semaglutide: RR, 0.67 (95 % CI: 0.62,0.72); tirzepatide vs. dulaglutide: RR, 0.55 (95 % CI: 0.51,0.59)",
   "Randomized trials are needed to confirm these findings"
  ],
  "41883294": [
   "We identified 49 semaglutide-, 54 sitagliptin-, and 42 dapagliflozin-associated erectile dysfunction reports.",
   "semaglutide (reporting odds ratio: 1.53, 95% confidence interval: 1.16-2.03; information component025 = 0.19), sitagliptin (reporting odds ratio: 1.52, 95% confidence interval: 1.16-1.98; information component025 = 0.20), and dapagliflozin (reporting odds ratio: 1.51, 95% confidence interval: 1.11-2.04; information component025 = 0.13)",
   "Other agents in the same drug classes, including dulaglutide, linagliptin, and metformin, did not show significant signals.",
   "These findings do not establish causality and should be regarded as preliminary and hypothesis-generating."
  ],
  "40240532": [
   "Among 182 cases identified, patients were predominantly aged 40-60 years, with exenatide accounting for 24.2% of reports, followed by semaglutide (21.4%).",
   "low ROR (0.41, 95% Confidence interval (CI): 0.36-0.48)",
   "suggest a weak association"
  ],
  "42011503": [
   "Eight studies, including 375 subjects, evaluated the effects of GLP1-RAs",
   "Only GLP1-RAs significantly increased total and calculated free testosterone along with gonadotropins.",
   "the use of testosterone replacement therapy (TRT) showed better results as compared to GLP1-RAs when orgasm and sexual satisfaction domains were investigated"
  ],
  "41544705": [
   "Two hundred and fifteen patients had total testosterone measured before and during incretin therapy",
   "Incretin therapy resulted in a 5% weight loss",
   "Total testosterone increased from 332 ± 134 to 399 ± 152 ng/dL (P < .001)",
   "the percentage of patients with normal total testosterone increased from 67% to 86%"
  ],
  "41291666": [
   "Four studies comprising 219 patients pre-treatment and 216 post-treatment were included.",
   "Free testosterone (MD -1.62; p = 0.051) and SHBG (MD -6.62; p = 0.120) showed no significant changes."
  ],
  "40604795": [
   "A total of 83 patients with obesity (mean age 55.3 ± 5.5 years) were included in the study, divided into three groups",
   "along with a notable increase in LM and IIEF-5 score compared to Groups B and C"
  ],
  "39511836": [
   "We designed a randomised open-label trial in 25 men with type 2 diabetes",
   "whereas the IIEF-15 score significantly improved only in the TRT group"
  ],
  "15213209": [
   "Randomized, single-blind trial of 110 obese men (body mass index > or =30) aged 35 to 55 years, without diabetes, hypertension, or hyperlipidemia",
   "The mean (SD) IIEF score improved in the intervention group (from 13.9 [4.0] to 17 [5]; P<.001), but remained stable in the control group (from 13.5 [4.0] to 13.6 [4.1]; P =.89).",
   "Seventeen men in the intervention group and 3 in the control group (P =.001) reported an IIEF score of 22 or higher."
  ],
  "34644814": [
   "5 studies with 619 participants were enrolled in our meta-analysis",
   "The mean difference of IIEF between weight loss group and control group was 1.99 with p < .01."
  ],
  "41404471": [
   "We established a theoretical model for how GLP-1 agonist modulation via increased serotonergic activity at the 5-HT2C receptor may result in diminished sexual desire.",
   "Failing to systematically measure and report on sexual desire as a potential adverse outcome of GLP-1 agonist use overlooks an essential aspect of patient well-being."
  ],
  "42661473": [
   "Regulatory labels mainly inform genital-safety counseling and nonclinical reproductive toxicology language.",
   "These drugs should be selected for metabolic indications, not as treatments for ED or infertility."
  ],
  "41867241": [
   "GLP-1 receptor agonists and SGLT2 inhibitors show promising vascular benefits with mixed erectile outcomes"
  ]
 },
 "noakes_ijir_2026_quotes": [
  "Published: 16 March 2026",
  "Two competing narratives have emerged.",
  "raising the question of whether a true safety signal exists or whether observed associations reflect confounding, detection bias, or rare idiosyncratic effects"
 ],
 "sellke_eisenberg_ijir_2026_10_19_quotes": [
  "Published: 19 October 2026",
  "In this context, the beneficial effects on erectile function are most plausibly indirect based on the current literature",
  "However, there is no evidence to support a direct effect of GLP-1 receptor activation on this effect in eugonadal men.",
  "These adverse effects were most commonly seen in men using exenatide but were also seen with contemporary GLP-1 RA such as semaglutide",
  "These observations should not be viewed as definitive evidence of harm but do warrant further investigation.",
  "However, rapid weight loss and nutritional deficits could influence libido, energy levels, or sexual performance.",
  "Competing interests The authors declare no competing interests."
 ],
 "label_term_counts": {
  "wegovy": 0,
  "ozempic": 0,
  "zepbound": 0,
  "mounjaro": 0
 },
 "zepbound_label": {
  "set_id": "487cd7e7-434c-4925-99fa-aa80b1cc776b",
  "effective": "20260828",
  "quotes": [
   "No effects of tirzepatide were observed on sperm morphology, mating, fertility, and conception."
  ]
 },
 "x_trending_story": {
  "id": "2115318919309209846",
  "name": "GLP-1 Weight-Loss Drugs Fuel Mixed Reactions on Rapid Changes and Risks",
  "updated_at_utc": "2026-10-28T05:50:01.000Z",
  "quote": [
   "studies linking them to higher risks of pancreatitis, bowel obstruction, gastroparesis, and erectile dysfunction in non-diabetics"
  ],
  "disclaimer": "This story is a summary of posts on X and may evolve over time. Grok can make mistakes, verify its outputs."
 },
 "chart_data": {
  "able": [
   [
    "ED diagnosis or ED-pill prescription",
    1.47,
    0.32
   ],
   [
    "Testosterone deficiency diagnosis",
    1.53,
    0.8
   ]
  ],
  "forest": [
   [
    "Randomized trial",
    "REWIND, dulaglutide vs placebo, T2D (2021)",
    0.92,
    0.85,
    0.99
   ],
   [
    "Health-record cohorts",
    "Semaglutide vs no semaglutide, obesity, no diabetes (2024)",
    4.5,
    2.3,
    9.0
   ],
   [
    "Health-record cohorts",
    "GLP-1 vs DPP-4 inhibitor, T2D (2026)",
    1.26,
    1.08,
    1.46
   ],
   [
    "Health-record cohorts",
    "Tirzepatide vs sitagliptin, T2D (2025)",
    0.7,
    0.64,
    0.76
   ],
   [
    "Health-record cohorts",
    "Tirzepatide vs injectable semaglutide, T2D (2025)",
    0.67,
    0.62,
    0.72
   ],
   [
    "Health-record cohorts",
    "Tirzepatide vs dulaglutide, T2D (2025)",
    0.55,
    0.51,
    0.59
   ],
   [
    "FDA adverse-event reports",
    "Semaglutide, ED reports (2026)",
    1.53,
    1.16,
    2.03
   ],
   [
    "FDA adverse-event reports",
    "All GLP-1s, male sexual dysfunction (2025)",
    0.41,
    0.36,
    0.48
   ]
  ]
 }
}