Emerging Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Male Sexual Hormones and Behaviors: Systematic Review and Meta-Analysis.
Level 2 - randomized trial
Systematic review including both observational studies and randomized controlled trials
PubMed 42011503 · doi:10.1111/andr.70238
What was done
Systematic review and meta-analysis following PRISMA and MOOSE guidelines, searching Medline from 1969 to August 2025. It evaluated observational studies and randomized controlled trials assessing the effects of GLP-1 receptor agonists (GLP1-RAs) or SGLT2 inhibitors (SGLT2is) on hormonal and sexual parameters in overweight and obese men with or without diabetes mellitus.
What was found
The abstract reports no numerical effect sizes, confidence intervals, or p-values. Eight studies (375 subjects) evaluated GLP1-RAs and three studies (52 subjects) evaluated SGLT2is. Both drug classes showed improvements in body composition, metabolic profiles, and erectile function. Only GLP1-RAs significantly increased total and calculated free testosterone and gonadotropins, which was reported to be independent of weight loss. Testosterone replacement therapy showed superior outcomes compared to GLP1-RAs for orgasm and sexual satisfaction domains.
Why it matters
This review aggregates early clinical evidence suggesting GLP-1 RAs may directly modulate the hypothalamic-pituitary-gonadal axis to improve obesity-associated male hypogonadism and erectile dysfunction beyond simple weight loss.
Limits
The total sample size is very small (427 total subjects across 11 studies, with only 52 subjects for SGLT2is). The analysis combines observational studies with randomized trials, and the abstract omits all numerical effect estimates, confidence intervals, and follow-up durations.
Cited by
- supports Men taking GLP-1 receptor agonists experience improvements in testosterone levels.