Ozempic (Semaglutide) and Penis Health: Understanding "Ozempic Penis"
Semaglutide (Ozempic) may cause erectile dysfunction in non-diabetic obese men, with research showing a 4.5 times higher risk compared to controls, while potentially improving sperm morphology in men with functional hypogonadism. 1, 2
Effects of Semaglutide on Male Sexual Function
Erectile Dysfunction Risk
- Recent research from a 2024 TriNetX database study found that non-diabetic obese men prescribed semaglutide for weight loss had a significantly higher risk of developing erectile dysfunction compared to matched controls:
- 1.47% vs 0.32% developed ED or required PDE5 inhibitors (Risk Ratio: 4.5) 1
- This study specifically examined men aged 18-50 with BMI >30 who were prescribed semaglutide after June 2021
Testosterone Levels
- The same study found that semaglutide use was associated with an increased risk of testosterone deficiency:
- 1.53% vs 0.80% developed testosterone deficiency (Risk Ratio: 1.9) 1
- This suggests a potential hormonal mechanism for the observed sexual dysfunction
Potential Benefits for Some Men
- Contrasting with the ED risk, a 2025 randomized open-label trial found that semaglutide actually improved certain aspects of male reproductive health in men with obesity, type 2 diabetes, and functional hypogonadism: 2
- Significant increase in morphologically normal sperm (2% to 4%, p=0.012)
- Increased total testosterone levels
- Improved symptoms of hypogonadism
Mechanism of Action and Implications
How Semaglutide Works
- Semaglutide is a GLP-1 receptor agonist that acts on receptors in multiple organs including the pancreas, GI tract, and brain 3
- Its primary mechanisms include:
- Delayed gastric emptying
- Inhibition of food intake
- Glucose-dependent stimulation of insulin secretion
Potential Mechanisms for Sexual Effects
- The exact mechanism for "Ozempic penis" (erectile dysfunction) is not fully established, but may involve:
Clinical Considerations
Risk Factors and Monitoring
- Clinicians should consider:
- Monitoring sexual function in men prescribed semaglutide, particularly non-diabetic men using it for weight loss
- Assessing baseline testosterone levels before initiating therapy
- Discussing potential sexual side effects as part of informed consent
Management of Sexual Side Effects
- For patients experiencing erectile dysfunction while on semaglutide:
- Consider dose adjustment if significant side effects occur 3
- Evaluate for testosterone deficiency
- Consider PDE5 inhibitors for management of ED symptoms
- Weigh benefits of continued weight loss against sexual side effects
Balancing Benefits and Risks
Substantial Benefits of Semaglutide
- Significant weight loss (3.47-6.5 kg on average) 3, 4
- Reduction in cardiovascular events by 13-26% in patients with established cardiovascular disease 3
- Improved glycemic control with 1.5-1.9% HbA1c reduction 5
Common Side Effects
- Gastrointestinal disorders are the most common adverse events (Risk Ratio: 1.98) 4, 6
- Increased risk of gallbladder disease (cholelithiasis) 3, 6
- The sexual side effects must be considered alongside these known issues
Conclusion
The term "Ozempic penis" appears to refer to the increased risk of erectile dysfunction associated with semaglutide use, particularly in non-diabetic obese men using it for weight loss. While semaglutide offers significant benefits for weight management and cardiovascular health, patients and clinicians should be aware of this potential side effect and monitor for changes in sexual function and testosterone levels during treatment.