Effects of GLP-1 analogs on metabolic alterations including male sexual function, hypogonadism and erectile dysfunction: a narrative review

Background and Objective: Metabolic alterations in chronic diseases such as dyslipidemia, type 2 diabetes mellitus (T2DM), and obesity disrupt hormonal regulation and perpetuate inflammation and oxidative stress across multiple systems, including the reproductive system. Focusing on the physiological functions of glucagon-like peptide-1 (GLP-1) and the organ-wide effects of its analogues, this review clarifies their mechanisms of action and long-term consequences, particularly regarding weight loss, oxidative stress, inflammation, and endothelial dysfunction.

Methods: A narrative literature search was performed in PubMed, Science Direct, and Web of Science databases, with the search date set on March 20, 2026 using Medical Subject Headings (MeSH) terms such as GLP-1, GLP-1RA, obesity, male sexual dysfunction, and employing the Boolean operators “AND” and “OR” to retrieve relevant information about metabolic syndrome, body mass index (BMI), male infertility, endothelial dysfunction, hypogonadism and erectile dysfunction (ED).

Key Content and Findings: The primary emphasis is on the impact of GLP-1 analogs in obesity, highlighting their potential for treating hypogonadism and ED, and establishing their role as a therapeutic approach that addresses key mechanisms underlying metabolic and reproductive pathology. This review examines how GLP-1 analogue treatment, initially developed for T2DM, is now being extensively repurposed for patients with obesity to address these systemic metabolic disturbances, and also examines its effect on male sexual function, ED hypogonadism, and infertility.

Conclusions: Even though these drugs were initially administered to improve metabolic control in patients with T2DM, numerous studies have demonstrated that the beneficial effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) extend beyond glucose and weight control, including positive effects on male sexual and reproductive functions.