A recent target trial emulation suggests that the use of GLP-1 receptor agonists in men with Type 2 diabetes is associated with a modestly increased rate of erectile dysfunction.
While evidence on GLP-1s and male sexual health has been inconsistent, erectile dysfunction is a significant complication for this demographic, affecting nearly half of men with Type 2 diabetes over their lifetime.
Researchers analyzed data from over 10,000 men with Type 2 diabetes in the U.S. between January 2019 and September 2024, comparing users of GLP-1s with those taking dipeptidyl peptidase-4 inhibitors (DPP4i). Excluded were men with pre-existing erectile dysfunction or end-stage renal disease.
The study found an incidence of erectile dysfunction of approximately 35 cases per 1,000 person-years in the GLP-1 group, compared to 28 per 1,000 person-years in the DPP4i cohort. This indicates about a 26% higher risk of developing erectile dysfunction for GLP-1 users over a three-year follow-up.
These findings suggest that sexual health outcomes should be considered for men with Type 2 diabetes treated with GLP-1s. Further randomized trials are recommended to explore this association and potential biological mechanisms, though researchers caution that causation was not established and results may be affected by biases.