By now you’ve probably heard about GLP-1s, sold under brand names such as Ozempic and Wegovy. This class of medications mimics naturally occurring hormones involved in appetite control and blood sugar regulation to treat type 2 diabetes and aid weight-loss efforts. It should be no surprise, then, that conversations around these popular drugs have largely centered on the scale. However, some scientists are starting to look more closely into how they may impact something perhaps even more personal: our sex lives.
At present roughly one in five Americans reports taking or having taken a GLP-1, according to a recent poll. As the number of people using these medications has soared, so have anecdotal reports about how they’re impacting users’ day-to-day—and yes, this includes things like pleasure and sex drive. Though there hasn’t been a ton of research into the relationship between sexual health and GLP-1s yet, more scientists are starting to investigate potential impacts.
In a review published in Obesity Pillars in March 2026, for example, researchers propose that GLP-1s may influence desire by impacting brain chemistry. But how exactly might these drugs impact sex drive? And is there a way to remain engaged in your sex life while on a GLP-1? We tapped experts to find out.
GLP-1 agonists may lessen your, ahem, thirst while dialing back hunger.
To understand how GLP-1s might influence libido, it helps to walk through how they work more broadly.
Some options, like Wegovy and Ozempic, contain semaglutide, which is a synthetic version of a naturally occurring hormone, glucagon-like peptide-1, or GLP-1. Semaglutide binds to GLP-1 receptors throughout the brain and body, helping regulate appetite, blood sugar, and feelings of satiety, James Simon, MD, an ob-gyn and reproductive endocrinologist and one of the researchers behind the Obesity Pillars study, tells SELF.
Other options, like Zepbound and Mounjaro, contain a different active ingredient called tirzepatide, which mimics both GLP-1 and a related hormone, and thus impacts the body in similar ways to semaglutide.
On top of reporting reduced appetite and increased satiety, a number of patients have also found that these weight-loss medications quiet what they call “food noise.” But as it turns out, the same parts of the brain that control appetite are also responsible for other reward-seeking behaviors, according to Dr. Simon. He says this could help explain why taking GLP-1s may have the auxiliary impact of decreasing appetite for another pleasurable activity: sex.
On top of that, early research suggests that GLP-1s may affect certain serotonin receptors, including one called 5-HT2C. This is thought to be a key player in the sexual side effects often experienced by those taking selective serotonin reuptake inhibitors (SSRIs), such as reduced libido and delayed orgasm.
“We know that, while SSRIs are fantastic options for anxiety and depression, they can have a significant impact on sexual desire and orgasmic function in both men and women,” says Dr. Simon. “It makes sense that other medications that also impact serotonin pathways might have similar impacts on sexual desire in some individuals.”
These meds may also affect the pelvic-floor function.
Sexual function isn’t just about hormones and brain chemistry. It also depends on the pelvic floor, a group of muscles that support the bladder and bowel, among other organs, and play an active role in arousal and orgasm, explains pelvic-health physical therapist Iris Xu, PT, DPT, of Fusion Wellness & Femina Physical Therapy.
“During arousal the pelvic-floor muscles increase blood flow to the genitals,” Dr. Xu says. During penetration the muscles lengthen and relax to allow for comfortable insertion and boost sensation. And during orgasm they contract rhythmically, creating the pulsing feeling associated with climax, she says.
In general, weight loss—from GLP-1s or other methods—can improve pelvic-floor function because reduced abdominal pressure means the muscles don’t have to work as hard to support the pelvic organs, Dr. Xu says. A 2024 study published in Archives of Gynecology and Obstetrics found that women carrying more fat, particularly in the pelvic area, had weaker pelvic floor muscles than those with less.
But GLP-1s don’t just encourage fat loss. Because these medications can lead to relatively rapid weight loss, preserving lean muscle mass can be challenging—especially without adequate protein intake or resistance training, says Dr. Xu. “[GLP-1s] can also cause loss of lean body mass and strength, especially when used in isolation without exercise or diet modifications,” she adds. In extreme cases this can lead to a condition called sarcopenia, which some studies have linked to reduced pelvic floor function. (FWIW, muscle loss can occur no matter how you lose weight. But by accelerating the weight-loss process, GLP-1s may speed up muscle loss as well.)
At the time of writing, research specifically examining GLP-1 medications and pelvic-floor outcomes remains limited. There is also little data on these drugs’ impact on muscle loss. But the research we do have points to this being a likely outcome, and Dr. Xu says losing too much lean mass may weaken pelvic floor support. This, in turn, can affect arousal, orgasm intensity, or overall sexual function.
Rapid weight loss can shift how you feel in your body.
As mentioned earlier, part of the notoriety of these medications is the speed at which many patients lose weight. Research has shown that, on average, people who are overweight or living with obesity can lose anywhere from roughly 10% to 20% of their total body weight on a GLP-1, depending on factors like which drug they use, what dose they take, and how long they continue treatment.
However, despite cultural messages to the contrary, weight loss does not automatically translate to increased body confidence and desire, Joy Berkheimer, PhD, LMFT, a sex and relationship therapist, tells SELF.
“Particularly if you have a long history of having your body policed against external beauty standards—as most women and people assigned female at birth do—the rapidity of the physical changes can lead you to feel unfamiliar in your body,” she says. Sexual desire and pleasure are often closely tied to embodiment, so a lack of embodiment can impact intimacy, she says.
For some, GLP-1s can bring about physical changes that actually increase sexual desire.
It’s not all bad news; for some people the broader health changes associated with these drugs may actually improve aspects of sexual well-being. People go on GLP-1s for help with a variety of health conditions, such as obesity, insulin resistance, type 2 diabetes, and polycystic ovarian syndrome (PCOS), to name just a few. Addressing these sorts of underlying issues may benefit sexual health.
That means even if the medications dial down some of the brain signals tied to desire, other changes happening in the body (e.g., improved energy, hormone balance, and physical comfort) may help support a healthier sex life, Dr. Simon tells SELF.
“Fat cells are highly inflammatory and impede our well-being far beyond their impact on our weight, leading to things such as joint pain and muscle fatigue,” he says. Feeling weak and achy can reduce interest in any physical activity—sex included!—as well as decrease pleasure during them. But as fat mass decreases and inflammation drops, people may feel more comfortable, energetic, and ultimately sexier. Additionally, as body composition improves, hormone levels may shift in ways that boost sexual desire and function, particularly in those with dysfunction, Dr. Simon says. (Body fat contains enzymes that can convert testosterone into estrogen. When levels of these hormones are unbalanced, it can impact sexual health.)
GLP-1 medications have also been shown to improve markers associated with vascular health, including blood pressure. Healthy blood flow is essential to arousal in people of all genders, says Dr. Simon. For those with vaginas it supports clitoral engorgement, lubrication, and vaginal expansion.
Finally, as metabolic health improves some people will see an increase in their energy levels and feel more comfortable in their bodies, says board-certified bariatric surgeon and obesity medicine specialist Betsy Dovec, MD, FACS, DBOM. For some—particularly those navigating postpartum body changes or the menopause transition—that renewed energy and groundedness can translate into increased confidence and desire, she says.
Taken altogether these physiological shifts can enhance sexual function for some people, even as the medications potentially continue to lower the volume on certain reward pathways.
Social, cultural, and interpersonal relationship factors can also lead to increased desire while on a GLP-1.
Of course, our sex lives aren’t driven by biology alone. They are mediated by culture and society, the relationships we’re in, our sense of self and self-confidence, and more. The broader life changes that can accompany weight loss may shift libido north or south.
In a society that often equates thinness with desirability, people who don’t fall into the narrow confines of “thin” may feel undesirable, unsexy, or even undeserving of pleasure. For some individuals changes in body composition toward that supposed ideal may lead to increased confidence.
A 2025 survey from the Kinsey Institute and DatingAdvice.com found that 59% of GLP-1 agonist users said the medication had an impact on their dating life, with a number saying it boosted their confidence. Justin Lehmiller, PhD, a social psychologist, research fellow at the Kinsey Institute, and host of the Sex and Psychology podcast, tells SELF that confidence can have huge impacts on our sexual satisfaction.
“Feeling confident makes it easier to surrender to pleasure and facilitates communicating about our sexual needs and desires, which helps to ensure that we’re getting more of what we want in bed,” he says. “By contrast, when we aren’t feeling confident, it’s easy to get stuck in our heads during intimacy and start worrying about things like how we look.”
For those who are single, increased self-confidence may inspire someone who previously didn’t use dating apps or go out to bars because of body image hang-ups to start putting themselves in situations where connection feels more possible, Dr. Simon says. Meanwhile, in long-term relationships that confidence could translate into greater willingness to initiate sex or say yes to a partner’s advances, he adds. It may also mean someone feels more comfortable experimenting with positions they once shied away from—potentially even discovering ones that bring them more pleasure.
In these cases the reward pathways are still muted. However, because other things that shape sexual desire and enjoyment (like confidence) have increased, patients on these drugs may be experiencing better and/or more sex overall.
It’s important to remember that libido changes are normal—but still worth exploring.
“Changes in libido are among the most common concerns people bring into sex therapy,” Dr. Berkheimer says. “But often they are a completely normal response to life transitions or physiological shifts, rather than a sign that something is wrong.”
Desire isn’t static, she explains. Rather, it fluctuates across the lifespan in response to factors like stress, sleep quality, exercise routine, medication, illness, hormones, relationship dynamics, and more. That means any shifts you notice after starting a GLP-1 medication aren’t necessarily a sign that something is off—your body might just need time to adjust, Dr. Berkheimer says. Still, if the change feels distressing or different enough to affect your well-being or relationships, it’s worth bringing up with your doctor.
Sexual health, Dr. Dovec says, isn’t a frivolous concern. “Pleasure matters. Intimacy matters. Feeling sexy matters. These are at the core of quality of life,” she says. Shifts in sexual desire and function can offer useful information about what’s happening in your body more broadly. So if sexual changes happen, talk to your provider. As frustrating or unwelcome as these shifts can be, they’re often temporary or solvable with a provider’s help, according to Dr. Dovec.
Sometimes the solution is as simple as adjusting GLP-1 dosage or timing; other times a clinician may suggest lifestyle changes, like adjusting your diet or exercise routine, or additional treatments that support hormone balance.
Not sure how to start the conversation? Dr. Dovec suggests keeping it simple: “You can just say, ‘Something feels different,’ or ‘I don’t feel like myself sexually.’ You’re not going to shock or embarrass your doctor.”
If you find yourself missing pleasure during this season of libidinal lull, Dr. Berkheimer encourages approaching your body with curiosity rather than pressure and expanding intimacy beyond intercourse. “That can look like slowing down and focusing on sensation instead of performance, exploring non-goal-oriented touch like massage or extended skin-to-skin contact, [or experimenting with] sex toys or pleasure aids,” she tells SELF.
Working with a body-neutral or Health at Every Size (HAES) sex therapist can also help you navigate medication effects, physical changes, identity, cultural conditioning, and more so you can erect an updated pleasure practice that honors the body you’re in now, Dr. Berkheimer adds.
Related:
- On a GLP-1? This Is the Workout Plan That Helps You Keep Muscle
- How GLP-1s Are Quietly Reshaping Gym Culture
- The Ultimate Grocery List for GLP-1 Users, According to a Dietitian
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