Semaglutide May Raise Libido, Patients Say

Changes in sex drive may be the side effect of semaglutide no one seems to talk about.

Semaglutide, sold under the brand names Ozempic, Rybelsus, and Wegovy, belongs to a class of type 2 diabetes and obesity drugs called GLP-1 receptor agonists. The medications can help lose up to 20% of body weight and have shown promise in curbing addictions, reducing dementia risk, and improving longevity.

Reddit users have recently shared what seems to be an unexpected side effect of semaglutide — changes in sex drive.

A 67-year-old user said their libido has been practically nonexistent since the onset of menopause about a decade ago. However, after starting semaglutide, the Redditor noticed increased vaginal lubrication.

"I am enjoying romantic movies more and surprising my husband in the morning. I don't want the roaring libido of my 40s back, but this is kinda nice. Anybody else?" the user asked.

A 30-year-old male Redditor said after the first semaglutide injection, their already high sex drive increased even more.

They wrote, "I'm back to feeling like a teenager during summer vacation. Not a bad time to be single since I'm also looking at getting a vasectomy soon, but, wow, talk about a boost."

Some people, however, report reduced libido. One Redditor said they used to have a high sex drive and now they are "just not that into it."

How does obesity affect sexual function?

Martin Binks, Ph.D., a professor and chair of the Department of Nutrition and Food Studies at George Mason University, says the sexual quality of life (SQOL) can be impaired in both men and women with obesity.

Individuals with obesity may experience a lack of enjoyment of sexual activity, a lack of sexual desire, and difficulties with sexual performance. Those with more severe forms of obesity are most affected, according to Binks.

For example, a study found that about 60% of women who sought bariatric surgery for weight loss reported sexual dysfunction. Obese men are also more likely than those with normal weight to have erectile dysfunction (ED).

How can semaglutide change libido?

Eduardo Grunvald, M.D., FACP, a medical director of the Center for Advanced Weight Management, says there could be two explanations for increased libido while on semaglutide.

The first is psychosocial, as with weight loss, there may be newfound self-esteem, socialization, and attention from potential romantic partners.

"All of this may unmask previously inhibited behaviors due to internalized bias and shame related to obesity," Grunvald tells Healthnews.

Another reason may be physiologic, Grunvald says. Fat cells cause aromatization, a process of converting testosterone into estrogen in both men and women.

"Theoretically, less fat tissue may cause relative elevations of testosterone, which tends to increase libido," he adds.

Binks says studies have shown that surgical and non-surgical weight loss can be associated with improvements in SQOL. Therefore, weight loss while on semaglutide is a likely contributor to increased libido while on semaglutide.

GLP-1s often decrease libido

The majority of human and animal studies suggest that direct mechanisms of action of GLP-1 agonists are more likely to exert a negative influence on SQOL, such as reduced desire and physical arousal, according to Binks.

However, these direct effects do not occur in a vacuum, and in the context of overall health and psychological improvements and weight loss, the anecdotal reports of increased sex drive are not surprising. Although, there are too few scientific studies to draw definitive conclusions.

Binks

Grunvald says a decrease in libido could be an off-target effect of semaglutide affecting the reward centers of the brain.

"They obviously dampen the reward of food, but in some cases also to alcohol and smoking, and even cases of gambling and perhaps drug use," Grunvald tells Healthnews.

A 2024 study found that men without diabetes prescribed semaglutide were much more likely to be diagnosed with erectile dysfunction than those who never took the drug. However, the rates of ED in men on semaglutide were overall low at 1.4%.

Sexual function can also be negatively affected by other drugs used to treat obesity and comorbid conditions. These medications include antihypertensives, sympatholytic agents, and antidepressants.

Semaglutide's effect on sexual function and drive may differ from person to person. It is a good idea to discuss any changes that impact your quality of life with your healthcare provider.