So much for “morning glory”…or was it the “glory of Rome”? Yet another study demonstrating that the blockbuster GLP-1 drugs are far from benign and bound to wreak havoc on society if their widespread use is not promptly curbed. One of the main reasons people consider using GLP-1 agonists is to improve physical appearance, which improves social confidence and interactions, thus leading to improved sexual function and life. Well, as it seems, those drugs come with a hefty price tag. While they may reduce weight (through essentially chemically induced fasting), this comes at the cost of ruined sexual function. Something very similar happened with the SSRI drugs for depression when they entered clinical practice 3+ decades ago. It is well-known that depressed people have very poor sexual function and desire, and the hope was that by relieving depression the SSRI drugs will address that issue as well. However, the exact opposite outcome happened and these days there is even a medical term to describe this fiasco. Namely, the so-called “SSRI-induced sexual dysfunction”. If serotonergic drugs kill sexual desire, and GLP-1 agonist drugs do the same, it would be natural to expect that a common mechanism is at play. As the study below shows, GLP-1 agonist drugs activate one of the serotonin receptors. Namely, the serotonin 5-HT2C receptor, which also happens to be the main controller of cortisol synthesis. So, by activating 5-HT2C, the anti-obesity drugs may also be putting people in a state of cortisol excess, which may have terrible consequences for health down the line, including for weight. Cortisol is well-known to induce the so-called “central obesity”, so these drugs may not only kill the party “down there”, but may also compromise the very goal – obesity – they were developed to achieve. The good news is that 5-HT2C antagonists (e.g. cyproheptadine) have been shown to ameliorate the SSRI-induced sexual dysfunction, so they may he helpful for the same issue caused by GLP-1 drugs, when the bill comes due years down the road after their widespread use.
https://pubmed.ncbi.nlm.nih.gov/8665544/
https://pubmed.ncbi.nlm.nih.gov/41404471/
“…We established a theoretical model for how GLP-1 agonist modulation via increased serotonergic activity at the 5-HT2C receptor may result in diminished sexual desire. We then applied a biopsychosocial framework to highlight why this effect may be overlooked by GLP-1-treated patients and clinicians. ”
Are GLP-1 Medications Impacting Your Sex Life? Here’s What the Research Says
“…Noticing changes in your sex drive while on a GLP-1 medication? You’re not imagining it, and you’re definitely not alone. GLP-1 medications like semaglutide and tirzepatide, commonly prescribed for weight loss and type 2 diabetes, are transforming how we think about metabolic health. But as their use becomes more widespread, experts are beginning to explore another, more personal question: how might these medications affect sexual desire and function? According to Dr. James Simon, a leading voice in this emerging research, the answer is complex. GLP-1 medications work by targeting brain pathways involved in appetite and reward. Because these same pathways also influence libido, some individuals may notice a decrease in sexual desire, similar to the effects seen with certain antidepressants that act on serotonin.”
