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Ozempic and Erectile Dysfunction: Treatment and Reviews

Ozempic Erectile Dysfunction

GLP-1 analogs, including Ozempic, have been linked to several side effects, some of which are still under investigation.

Erectile dysfunction is among these side effects; however, its association with Ozempic remains unclear as it is a common issue among individuals with diabetes, and patients may feel hesitant to discuss it.

Erectile dysfunction is about three times more common in diabetics compared to non-diabetics. It is not the only sexual side effect.

Diabetics may develop one or more of the following sexual side effects:

  • Erectile dysfunction
  • Reduced libido or the desire to have sex
  • Premature ejaculation
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Why do diabetics develop Sexual Dysfunction (ED and reduced libido):

Diabetes can contribute to erectile dysfunction (ED) in various ways, including:

  • Nerve damage:

Neuropathy is one of the common complications of diabetes. Autonomic neuropathy is when high blood sugar levels damage the nerves supplying the blood vessels.

This leads to impaired blood flow to the penis, especially in times of sexual activity when a large amount of blood is required to cause an erection.

Nerve damage can also lead to reduced sensations and erection is impaired when the penis is stimulated.

  • Hormonal imbalances:

Diabetes can cause imbalances in hormones like testosterone, which can affect sexual function and libido.

  • Cardiovascular disease:

Diabetics are more likely to have clinical or subclinical cardiovascular disease.

The blood vessels become stiff because of atherosclerosis resulting in an impairment of blood flow to the penis, especially during sexual activity leading to ED.

  • Medications:

Certain medications commonly used to treat diabetes and associated conditions like hypertension, neuropathy, depression, and heart diseases can contribute to ED as a side effect.

  • Psychological factors:

The stress and anxiety associated with managing diabetes can also contribute to ED, as can depression, relationship problems, and other psychological issues.

  • Lifestyle factors:

Lifestyle factors that often accompany diabetes, such as smoking, excessive drinking, poor diet, and lack of exercise, can also contribute to ED.

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Ozempic and Erectile Dysfunction:

The use of GLP-1 analogs such as Ozempic and Mounjaro may contribute to erectile dysfunction, but the exact mechanisms are not fully understood.

Although not mentioned as a side effect, people have reported significant sexual dysfunction with Ozempic and Mounjaro.

Sexual side effects are still grossly under-reported because of social stigma and people being uncomfortable sharing their sex-related experiences.

Here are some factors that may be causing Erectile dysfunction in patients using Ozempic and Mounjaro:

  • Reduced testosterone levels:

GLP-1 analogs have been shown to decrease testosterone levels in some patients, which can lead to erectile dysfunction and loss of libido.

  • Effects on the nervous system:

GLP-1 analogs may affect the autonomic nervous system, which plays a key role in the physiological response to sexual arousal. This could potentially contribute to erectile dysfunction.

  • Cardiovascular effects:

GLP-1 analogs may have beneficial effects on cardiovascular health, but they can also cause a decrease in blood pressure, which may contribute to erectile dysfunction.

  • Psychological factors:

Diabetes and its complications can cause psychological stress and anxiety, which can contribute to erectile dysfunction. The use of GLP-1 analogs may also cause anxiety in some patients.

Anxiety, fatigue, and palpitations are known side effects of GLP-1 analogs including Ozempic which may be indirectly contributing to poor erection.

  • Other medications:

Patients using GLP-1 analogs may also be taking other medications that can contribute to erectile dysfunction, such as blood pressure medications or antidepressants.

Weight loss with Ozempic can improve sexual functioning:

On the other hand, weight loss in patients using Ozempic or Mounjaro can have beneficial effects on sexual function and arousal.

Weight loss can potentially improve sexual function and increase libido, as it may help improve blood flow, decrease inflammation, and boost self-esteem and confidence.

However, weight loss resulting from performing exercise may be most effective in such cases compared to Ozempic, Mounjaro, or other weight loss drugs.

Hence, patients using Ozempic and exercising are more likely to benefit in terms of losing weight as well as improving sexual functions.

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Treatment of Sexual dysfunction in patients on Ozempic:

Improving sexual health in patients using Ozempic, Rybelsus, Wegovy, or Mounjaro should focus on:

  • Treatment of Erectile dysfunction
  • Treating loss of libido, and
  • Treating premature ejaculation.

Treating Erectile dysfunction in patients using Ozempic:

The management of erectile dysfunction in diabetics and patients using Ozempic is multifaceted and involves a combination of lifestyle changes, medications, and/or medical devices.

Here are some common approaches:

  • Lifestyle changes:

Regular exercise, a healthy diet, weight loss, quitting smoking, and reducing alcohol consumption can have significant beneficial effects on sexual health and ED in patients using Ozempic.

  • Medications:

Oral medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are commonly prescribed to improve blood flow to the penis and help achieve and maintain an erection.

Other medications such as alprostadil (Caverject, Edex) can be injected directly into the penis or inserted as a suppository into the urethra.

  • Medical devices:

Vacuum constriction devices can create a vacuum around the penis to increase the blood flow to the area.

Similarly, penile implants, which are surgically implanted and can allow for on-demand erections, are an option for some patients with advanced and refractory symptoms.

  • Psychological counseling:

Erectile dysfunction can improve with counseling and psychotherapy in about 50% of the patients.

  • Treatment of underlying conditions:

Managing blood sugar levels, high blood pressure, and high cholesterol can also improve erectile dysfunction in diabetics.

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Treatment of low Testosterone in patients with ED:

The treatment options for a diabetic patient with erectile dysfunction and low testosterone levels may include:

  • Testosterone Replacement Therapy (TRT):

TRT can help increase testosterone levels in the body and improve erectile function. Testosterone is available as tablets, patches, and injections.

It is also one of the ingredients in OTC supplements, however, the strength and dose may differ.

Testosterone should be replaced with caution in men over 50. A PSA (test for prostate cancer) should be done before testosterone replacement is advised.

  • Phosphodiesterase type 5 (PDE5) inhibitors:

Medications such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) can help improve blood flow to the penis and improve erectile function.

Cialis is the longest-acting PDE drug used on weekends for the symptomatic treatment of erectile dysfunction, while Viagra and Levitra are shorter-acting drugs.

Some experts suggest using Cialis on weekends and using Viagra and Levitra before sexual activity.

It is important to note that an erection with these drugs may not occur if there is no desire to do so. Thus, taking Cialis on weekends will help erections on other days when the person desires.

  • Vacuum erection devices (VEDs):

These are devices that help create an erection by using a vacuum to increase blood in the penis.

  • Penile injections:

Medications such as alprostadil can be injected directly into the shaft of the penis to help improve blood flow and achieve an erection without causing significant systemic effects.

  • Penile implants:

Penile implants are for those people who do not respond to other treatments. This involves surgically inserting a device into the penis that allows the patient to achieve an erection when desired.

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Management of Low Libido in diabetic patients using Ozempic:

The treatment options for a diabetic patient on Ozempic with reduced libido may include:

  • Switching to an alternative medication:

If Ozempic is causing reduced libido, switching to a different GLP-1 analog or medication may help improve libido.

However, one key component of treating libido is controlling blood glucose. Switching from Ozempic to another drug should be the last option as changing to other drugs may result in hyperglycemia which can further cause erectile and sexual dysfunction.

  • Testosterone replacement therapy:

If the patient has low testosterone levels, testosterone replacement therapy may be an option to improve libido.

Testosterone can be used as topical gels, tablets, or injections. OTC supplements also contain testosterone as one of the ingredients.

  • Counseling or psychotherapy:

Counseling or therapy may help address psychological factors that can contribute to reduced libido.

  • Lifestyle changes:

Making lifestyle changes such as increasing physical activity, improving diet, and reducing stress can help improve libido.

  • Medications for erectile dysfunction:

Medications such as Viagra, Cialis, and Levitra can improve erectile function in diabetic patients with ED but have little impact on improving libido.

These drugs are usually ineffective in people who do not have the desire to have sex.

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Treating Low Libido in Women using Ozempic:

The treatment options for a diabetic female with reduced libido may include:

  • Addressing underlying medical conditions:

Women with Diabetes and uncontrolled blood glucose and those with complications of diabetes like neuropathy, vision, and kidney problems may have significantly impaired sexual function including loss of desire to have sex.

Other conditions that can exacerbate the loss of libido include hypertension, high cholesterol, heart and kidney diseases, and depression in particular.

Controlling blood glucose and treating these conditions may help improve libido.

  • Hormone replacement therapy:

In some cases, reduced libido may be due to a hormonal imbalance. Hormone replacement therapy, including testosterone replacement therapy, may be helpful for some women.

However, over-treatment can result in acne, polycythemia, and male-like features including hair loss. Hence, testosterone replacement in females should be done only after consultation with a doctor.

  • Counseling or therapy:

If the reduced libido is due to psychological factors, counseling or therapy may be helpful. This can include individual therapy, couples therapy, or sex therapy.

  • Medications:

Certain medications, such as bupropion or flibanserin, may be prescribed to help improve libido in some women.

  • Lifestyle changes:

Lifestyle changes, such as regular exercise, a healthy diet, stress reduction techniques, and good sleep hygiene, may also help improve libido in some women.

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Treatment of premature ejaculation in diabetic patients using Ozempic:

Premature ejaculation is a common sexual problem that can occur in diabetic patients on Ozempic.

Here are some treatment options:

  • Behavioral therapy:

This includes techniques such as the squeeze and stop-start methods, which can help patients to better control their ejaculation.

  • Topical anesthetics:

These are creams or sprays that contain anesthetic agents such as lidocaine or prilocaine, which can help to reduce sensitivity and delay ejaculation.

  • Medications:

Certain medications such as selective serotonin reuptake inhibitors (SSRIs) can be used to treat premature ejaculation.

They work by delaying ejaculation, but they may also have side effects such as reduced libido and erectile dysfunction.

One of the commonly used SSRIs is Zoloft (Sertraline). Dapoxetine is another commonly used SSRI that is frequently used to treat premature ejaculation.

However, it is important to keep in mind that Zoloft can worsen erectile dysfunction in men.

  • Combination therapy:

Some patients may only benefit when the condition is targeted using different methods including behavioral therapy and medications or topical anesthetics.

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Summary of the management of sexual dysfunction in diabetic patients using Ozempic:


Treatment Options

Erectile Dysfunction
  • Oral phosphodiesterase type 5 inhibitors (e.g. sildenafil, tadalafil
  • Vacuum erection devices
  • Penile injections (e.g. alprostadil)
  • Penile implants
  • Testosterone replacement therapy (if low testosterone levels)
Reduced Libido
  • Testosterone replacement therapy (if low testosterone levels
  • Address underlying medical conditions (e.g. diabetes, depression)
Premature Ejaculation
  • Behavioral techniques (e.g. stop-start method, squeeze technique)
  • Topical anesthetics (e.g. lidocaine)
  • Oral medications (e.g. dapoxetine)
  • Counseling or therapy (e.g. sex therapy)

Treating Vaginal Dryness and Inability to Reach Climax in Diabetic Women Using Ozempic:

The treatment options for a diabetic female with vaginal dryness and inability to reach climax may include:

  • Lubricants:

Using over-the-counter or prescription lubricants can help reduce vaginal dryness and improve sexual satisfaction.

  • Hormone therapy:

Hormone therapy, including estrogen therapy, can help increase vaginal lubrication and improve sexual desire.

  • Pelvic floor exercises:

Pelvic floor exercises, such as Kegels, can help strengthen the muscles in the pelvic region and improve sexual function.

  • Cognitive-behavioral therapy (CBT):

CBT can help identify and address any psychological issues that may be contributing to reduced sexual desire or difficulty achieving orgasm.

  • Medications:

Some medications, such as sildenafil (Viagra), tadalafil (Cialis), and flibanserin (Addyi), may be prescribed to help improve sexual function in women.

  • Sex therapy:

Sex therapy can help address any issues related to sexual desire, arousal, or satisfaction and improve overall sexual function.

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Ozempic and Erectile Dysfunction: Patient’s reviews

Here are some positive and negative reviews of actual patients who have been using Ozempic and noticed a change in their sexual drive or developed erectile dysfunction.

A total of 13 negative reviews are posted here. 9 of them are by men while 4 reviews are of women. These patients developed sexual dysfunction after they were put on Ozempic [Ref].

Reviews of people who developed Erectile dysfunction/ sexual dysfunction using Ozempic:

I’m a 39-year-old man who didn’t experience any erectile dysfunction issues before starting Ozempic.

However, after using Ozempic for three months, I noticed a rapid drop in my testosterone levels, which led to erectile dysfunction. I’m currently undergoing treatment to fix this issue.



 I’m a 39-year-old man who experienced erectile dysfunction (ED) prior to starting Ozempic. I found that Cialis helped alleviate the symptoms.

However, after starting Ozempic on a higher dosage of 2mg, I noticed a decrease in ejaculation volume and retraction of my left testicle, as well as muscle weakness.

I purchased an over-the-counter male supplement that seemed to help the situation. I’m not sure if it was the supplement or another reason entirely.

I haven’t discussed this with my doctor yet, but reading about others who have experienced similar issues encourages me to bring it up with them.


A study has found that Ozempic works by lowering nitric oxide levels, which reduces hunger and appetite.

However, nitric oxide is also a critical component for achieving and maintaining an erection. As a result, I’ve decided to discontinue taking Ozempic.

While self-discipline and control are important for managing hunger and weight, it’s crucial to consider the potential impact of any medication on overall health and well-being.



 Are there any other men who are taking Ozempic and experiencing erectile dysfunction, either during intimacy with another person or during self-pleasure?


I’m a 55-year-old man who has been taking the third dose of .25 Ozempic. However, I’ve noticed either a less-than-full potential response or no response at all.

This change happened quickly after introducing Ozempic and didn’t happen gradually over time. I’m currently on testosterone therapy, which usually results in a strong and healthy response.

I’m scheduled to have blood work at the end of next month to determine if there were any negative impacts on my testosterone levels. It will be interesting to see if this issue is a long-term effect of the medication.



 My partner started taking Ozempic three weeks ago and has experienced the same symptoms as you.

It’s interesting to note that he is also 55 years old and has never had any issues before taking the medication.


I’m feeling a bit embarrassed to admit this, but since starting Ozempic 60 days ago and losing 18 lbs, I’ve been having trouble with erections for the past 3 weeks.

I’m wondering if it could be related to a lack of protein or muscle loss. I’m hoping to hear from other men who may have experienced similar issues and could provide some constructive feedback.



 If you’re a male over 45 with low libido or ED, it’s advisable to have your testosterone levels checked.

The fact that some women have also reported decreased libido while taking Ozempic is concerning.

Females may notice a more significant reduction in testosterone as they typically have lower levels, to begin with.


I have been taking it for 9 months and I am currently 37 years old. My doctor informed me that it would take too long to get my testosterone levels back to where they were two years ago.

He suggested that supplemental TRT may assist me in regaining my lost bone mass, as I lost a pound of bone mass due to prolonged prednisone use, followed by chemo and Humira.



 I’m a 32-year-old woman with type 1 diabetes, PCOS, and other health conditions. I started taking Ozempic in November, which has helped me manage my diabetes and lose 23kg.

However, I’ve noticed a decrease in my sex drive and have experienced dryness during sex. I’m looking for any solutions or advice that can help alleviate these symptoms.


Although I’m not a male, I wanted to share that I’m experiencing some issues with my libido as a female.

It’s especially distressing because I’ve lost weight and was hoping to feel more confident in my body.

However, it seems like I’ll have to wait to up my game in that department. It’s frustrating, to say the least.



 As a woman taking Ozempic, I’ve noticed a slight decrease in my libido.


As a female, I used Ozempic from March to August and noticed a decrease in my libido. When I increased the dosage to 1mg, I experienced difficulty reaching climax.

It was really disheartening and took a lot of the joy out of my sex life. I eventually decided to stop taking Ozempic, and within 4 weeks everything returned to normal.

It was a relief to finally feel like myself again. Coincidentally, I discovered that I was pregnant around the same time and had to discontinue use anyway.



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Positive reviews: People using Ozempic had improved sexual function including better erection with Ozempic:

Only three patients posted positive reviews about their sexual health using Ozempic.

I haven’t experienced any negative effects on my sexual function while taking Ozempic.

Although there are times when I’m too busy to think about sex, I still feel horny frequently and my erections are strong.

I’ve also noticed that my ejaculations have become stronger and bigger, which may be due to decreased inflammation and increased hydration.



 I’ve been taking Ozempic since December and haven’t experienced any issues like the ones you described. However, I did have similar problems while taking Qsymia.I had trouble reaching climax, and my doctor suggested I get tested for prostate and testicular problems. Interestingly, once I stopped taking Qsymia, those issues went away completely.

Currently, I’ve been taking Mounjaro for three weeks, and I haven’t had any issues so far. In fact, I prefer it over Qsymia as it seems to be easier on my stomach.

By the way, I’ve lost 60 pounds since starting Ozempic in December. Are you also taking Metformin?


I’ve been lucky enough to lose 82 pounds so far. I went from taking metformin twice a day to once a day and my blood sugar is well-controlled.

My A1C dropped from 7.2 to 4.6, with my last result being 2 weeks ago. My doctor checked my testosterone level and found that it had dropped from 800 to 350.

I gained 24 pounds of muscle and had a lot of energy, but it took a lot of effort. During my last appointment, my doctor and I decided to only take metformin sporadically to offset spikes in blood sugar, which are well-controlled since I added N-Acetyl cysteine as a daily supplement.



 Metformin had a tremendous impact on my testosterone levels, dropping them to over 100% lower than they were before, which was suboptimal and detrimental to my health as also reflected in my bone loss.However, I did not suffer from ED while on it, perhaps because of my workouts, diet, supplements, and minerals.

Last week, I started on Testosterone Replacement Therapy (TRT), with my doctor deciding on 200mg weekly for 2 weeks, then every other week.

On week 5, we will test my levels again and add Clomid so that I can maintain the new levels and keep my Gonad size.

So far, there have been no changes to my Ozempic doses (1g every week here, 7 months and 2 weeks here), hunger, or blood sugar.

As I started week 1 of TRT, I noticed much more strength when exercising. I can do more reps at a higher weight, feel less tired, sleep much better, and am less depressed and anxious.

I feel better overall, with rock-solid erections and increased libido. My mood has improved, and I’m experiencing better gains at the gym.

However, my weight loss has decreased to 1 pound per week for the last 2 weeks, where I was dropping 2-3 pounds per week before.

There have been no changes in my blood sugars so far, even though I tapered off metformin during the last month and now only take it sporadically.

I have more cravings for protein and the desire to add another workout session on a day despite not having the time to do so every day. But I’m adding that on the days I can!


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What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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