WASHINGTON -- Interest in GLP-1 receptor agonists as a potential aid to sexual desire and arousal disorders took off in the field of sexual medicine -- and landed with a thud.
"GLP-1s are not what I would call treatments for low desire or arousal because we've actually been seeing that they may negatively impact sexual function," said Jessica Yih, MD, of the University of California Irvine, during the Society of Sexual Medicine of North America session at the American Urological Association meeting.
Yih cited several recent examples:A case report linked initiation of GLP-1 treatment to new-onset anorgasmia in a woman.A retrospective cohort analysis showed a significantly increased risk of erectile dysfunction and testosterone deficiency in nondiabetic men taking GLP-1 agonists.A review of the FDA Adverse Events Reporting System turned up 182 cases of sexual dysfunction in men, including orgasmic dysfunction, erectile dysfunction, and decreased libido.A preclinical study showing reduced sexual interest and activity in sexually experienced female animals exposed to GLP-1 drugs.
GLP-1 receptor agonists may adversely affect sexual arousal and desire by two mechanisms, said Yih. Rapid weight loss induced by the drugs may increase levels of sex hormone-binding globulin and reduce levels of free testosterone, both of which can diminish libido and sexual arousal. Additionally, GLP-1 agonists can activate the serotonergic pathway, leading to increased serotonin load, which has been implicated in sexual dysfunction among users of selective serotonin reuptake inhibitors, a class of antidepressants.
