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Response to Comment on: Male sexual dysfunction associated with GLP-1 receptor agonists: a cross-sectional analysis of FAERS data

International Journal of Impotence Research volume 37, pages 693–695 (2025)Cite this article

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We thank Pozzi et al. [1] for their thoughtful commentary on our study, “Male Sexual Dysfunction Associated with GLP-1 Receptor Agonists: A Cross-Sectional Analysis of FAERS Data” [2], and for highlighting the need for increased attention to the sexual complications of GLP-1 receptor agonists (GLP-1RAs)—a class of medications whose usage has grown dramatically for the management of type-2 diabetes-mellitus (T2DM), obesity, and heart failure. We agree that while the therapeutic benefits of GLP-1RAs are substantial and widely acknowledged, our understanding of their full impact on sexual function remains incomplete. In this response, we aim to further contextualize our findings, clarify neurobiological mechanisms, address the conflicting clinical evidence, and emphasize clinical and research implications.

Our analysis of the FAERS pharmacovigilance database identified 182 reports of male sexual dysfunction temporally associated with GLP-1RA therapy, encompassing conditions such as erectile dysfunction (ED), orgasmic disorder, and decreased libido—most frequently reported in men aged 40–60 years [2]. The majority of these cases involved exenatide, semaglutide, and liraglutide, with report rates rising as GLP-1RA prescriptions expanded for weight management. However, the disproportionality measures—reporting odds ratio (ROR), proportional reporting ratio (PRR), and relative reporting ratio (RRR)—were all well below 1.0 (0.41–0.42), and the confidence intervals were wide, underscoring the overall low strength of association and high degree of uncertainty. We interpret these findings as indicative of both the reassuring safety profile of GLP-1RAs and, likely, underreporting of such complications. Ultimately, these results are hypothesis-generating rather than causative and warrant further investigation, especially as GLP-1RA use increases in both diabetic and non-diabetic populations.

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References

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Authors and Affiliations

  1. Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA

    Ashkan Pourabhari Langroudi & Michael L. Eisenberg

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  1. Ashkan Pourabhari Langroudi
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  2. Michael L. Eisenberg
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APL and MLE conceived the response. APL drafted the manuscript. All authors contributed to editing, and all approved the final version.

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Correspondence to Ashkan Pourabhari Langroudi.

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Langroudi, A.P., Eisenberg, M.L. Response to Comment on: Male sexual dysfunction associated with GLP-1 receptor agonists: a cross-sectional analysis of FAERS data. Int J Impot Res 37, 693–695 (2025). https://doi.org/10.1038/s41443-025-01155-x

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