(189) Effects of GLP-1 Receptor Agonists on Erectile Function and Ejaculation: A Systematic Review Article Swipe

Introduction Erectile dysfunction (ED) and ejaculatory disorders are common manifestations of male sexual dysfunction, particularly in men with obesity and type 2 diabetes mellitus (T2DM). These metabolic conditions contribute to endothelial dysfunction, hormonal imbalance, and neuropathic changes that compromise penile hemodynamics and ejaculatory control. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), increasingly used for metabolic disease management, have demonstrated pleiotropic effects beyond glucose regulation. Emerging evidence suggests a potential role in modulating sexual function, but the extent and mechanism of this impact remain unclear. Objective To evaluate the effects of GLP-1 receptor agonists on erectile function and ejaculatory parameters in men and animal models through a systematic review of the literature. Methods A systematic search was conducted using the MEDLINE database to identify relevant articles published between 2014 and March 2025. Keywords and MeSH terms included combinations of “GLP-1 receptor agonist,” “Semaglutide,” “Liraglutide,” “Erectile dysfunction,” “Ejaculation,” “Penile erection,” and “Sexual function.” Included studies were original research involving either human participants or animal models, and must have reported outcomes related to erectile function (e.g., IIEF scores, intracavernosal pressure) or ejaculatory metrics. Review articles, editorials, and studies not reporting sexual function outcomes were excluded. Two authors independently screened titles, abstracts, and full texts using Covidence software. Results Of 20 total studies screened, 10 met inclusion criteria. Six studies involved human subjects and four were conducted in animal models. Among the six human studies, five examined erectile function-four using validated instruments such as the International Index of Erectile Function (IIEF). Three of these reported significant improvements in erectile performance following treatment with GLP-1 RAs, particularly in patients with obesity or T2DM. Improvements correlated with reductions in HbA1c, weight, and inflammatory markers. One study reported no significant change. Regarding ejaculation, two human studies explored ejaculatory latency or satisfaction; both reported no adverse effect and one suggested improved ejaculatory control. In animal models, three of the four studies showed enhancement of erectile response, demonstrated through increased intracavernosal pressure and improved endothelial nitric oxide synthase (eNOS) activity. These effects were hypothesized to be mediated by improved vascular function and reduced oxidative stress. None of the animal studies reported data on ejaculatory parameters. Conclusions GLP-1 receptor agonists may offer modest benefits in improving erectile function, particularly in metabolically compromised men. Evidence points to mechanisms involving improved endothelial health, hormonal modulation, and weight-related metabolic improvements. While human data on ejaculation is limited, existing findings do not suggest adverse effects and may hint at improved control in some cases. Further randomized, controlled trials are warranted to clarify the role of GLP-1 RAs in male sexual medicine and to delineate their effects on ejaculatory physiology. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Verity Pharma