Can Ozempic Cause Erectile Dysfunction? Evidence and Management

Ozempic (semaglutide) is a GLP-1 receptor agonist widely prescribed for type 2 diabetes management in the UK. Some patients have raised concerns about whether Ozempic might contribute to erectile dysfunction (ED). Currently, there is no established link between semaglutide and ED according to the MHRA, EMA, or clinical trial data. Erectile dysfunction is multifactorial and commonly associated with diabetes itself, which damages blood vessels and nerves essential for sexual function. This article examines the evidence, explores contributing factors, and outlines management options for men experiencing ED whilst taking Ozempic.

Can Ozempic Cause Erectile Dysfunction?

Ozempic (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for the treatment of type 2 diabetes mellitus. It works by enhancing insulin secretion in response to elevated blood glucose levels, suppressing glucagon release, and slowing gastric emptying. Whilst Ozempic has demonstrated significant benefits in glycaemic control and cardiovascular outcomes in clinical trials such as SUSTAIN-6, patients occasionally raise concerns about potential effects on sexual function, including erectile dysfunction (ED).

There is no established link between Ozempic and erectile dysfunction according to the product's Summary of Product Characteristics (SmPC) or large-scale clinical trials. The Medicines and Healthcare products Regulatory Agency (MHRA) and the European Medicines Agency (EMA) do not list ED as a recognised adverse effect of semaglutide. Some patients have reported individual experiences that have prompted questions about whether the medication might theoretically influence erectile function, but there is currently insufficient evidence to support these associations.

It is important to recognise that erectile dysfunction is multifactorial and commonly associated with the underlying condition being treated—type 2 diabetes itself. Chronic hyperglycaemia can damage blood vessels and nerves essential for erectile function, a process known as diabetic vasculopathy and neuropathy. Therefore, distinguishing between disease-related ED and potential medication effects requires careful clinical assessment. Patients experiencing new or worsening erectile difficulties whilst on Ozempic should not discontinue treatment without medical advice, as optimal diabetes control remains paramount for long-term vascular and sexual health.

If you suspect Ozempic may be contributing to erectile dysfunction, you can report this as a potential side effect through the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

Other Factors That May Affect Erectile Function During Treatment

Several factors unrelated to Ozempic itself may contribute to erectile dysfunction during treatment, and understanding these is essential for accurate diagnosis and management.

Underlying diabetes and vascular disease remain the most significant contributors. Type 2 diabetes is strongly associated with ED, with prevalence rates ranging from 35-75% depending on age, diabetes duration and glycaemic control—approximately 2-3 times higher than in the general population. Persistent hyperglycaemia damages endothelial cells lining blood vessels, impairing nitric oxide production—a key mediator of penile erection. Additionally, diabetic autonomic neuropathy can disrupt the nerve signals required for normal erectile function. As Ozempic is prescribed for diabetes management, many patients may already have established microvascular or macrovascular complications.

Weight changes may influence sexual function. While moderate weight loss generally improves erectile function and testosterone levels in obese men, significant caloric restriction in certain contexts (such as very low-calorie diets or athletic training) can sometimes affect hormone balance. For most patients with type 2 diabetes, the weight loss achieved with GLP-1 receptor agonists is likely to be beneficial rather than detrimental to sexual function.

Psychological factors should not be overlooked. Anxiety about diabetes complications, body image concerns during weight loss, relationship stress, or depression can all significantly impair erectile function. The NHS recognises that psychological wellbeing is integral to sexual health, and these factors often coexist with chronic disease.

Concomitant medications frequently used alongside Ozempic may also contribute. Some antihypertensives (particularly older non-vasodilating beta-blockers and thiazide diuretics) have recognised associations with ED, as do certain antidepressants. The evidence regarding lipid-lowering medications is mixed, with some studies suggesting statins may have neutral or even beneficial effects on erectile function. A comprehensive medication review is therefore essential when evaluating new sexual dysfunction symptoms.

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What to Do If You Experience Erectile Dysfunction on Ozempic

If you develop erectile dysfunction whilst taking Ozempic, do not stop your medication without consulting your GP or diabetes specialist. Abrupt discontinuation may compromise glycaemic control and increase cardiovascular risk. Instead, arrange a consultation to discuss your symptoms in a confidential, supportive environment.

Your healthcare provider will typically conduct a thorough assessment including:

• Medical history review: Duration and severity of ED, onset in relation to starting Ozempic, presence of morning erections, and impact on quality of life

• Diabetes control evaluation: Recent HbA1c levels, duration of diabetes, and presence of known complications

• Cardiovascular risk assessment: Blood pressure, lipid profile, and screening for ischaemic heart disease

• Medication review: Identifying other drugs that may contribute to ED

• Hormonal screening: According to NICE Clinical Knowledge Summary (CKS) on Erectile Dysfunction, this should include morning testosterone levels (taken between 8–11 am) on two separate occasions if initial results are low. Additional tests may include luteinising hormone (LH), follicle-stimulating hormone (FSH), prolactin, and in some cases sex hormone-binding globulin (SHBG)

• Psychological assessment: Screening for depression, anxiety, or relationship difficulties

Lifestyle modifications remain first-line management and complement pharmacological diabetes treatment. These include:

• Optimising diabetes control to prevent further vascular damage

• Regular physical activity (150 minutes moderate-intensity exercise weekly)

• Smoking cessation and limiting alcohol intake

• Maintaining healthy body weight

• Stress management and adequate sleep

Your GP may also discuss phosphodiesterase-5 (PDE5) inhibitors such as sildenafil, tadalafil, or vardenafil, which are effective treatments for ED. Generic sildenafil can generally be prescribed on the NHS, while other PDE5 inhibitors remain subject to Selected List Scheme (SLS) restrictions, though diabetes is an eligible condition. These medications are generally safe to use alongside Ozempic, though contraindications (particularly nitrate use) must be excluded, and caution is needed if you are also taking alpha-blockers. If you have cardiovascular disease, your doctor may assess whether you are fit enough for sexual activity before prescribing.

Alternative Treatments and When to Speak to Your GP

If erectile dysfunction persists despite initial management, several alternative treatment options are available through the NHS:

Pharmacological alternatives include:

• Vacuum erection devices: Non-invasive mechanical aids that draw blood into the penis

• Intracavernosal injections: Alprostadil injections directly into the penis, producing erections within 5–15 minutes

• Intraurethral therapy: Alprostadil pellets inserted into the urethra

• Testosterone replacement therapy: Only for men with symptomatic hypogonadism confirmed by consistently low testosterone levels (typically <8 nmol/L) on two morning samples, with appropriate LH/FSH levels. This should be initiated and monitored by specialists, with regular checks of PSA and haematocrit

In cases where ED is refractory to medical management, specialist referral may be appropriate—to urology for consideration of penile prosthesis implantation, or to endocrinology/andrology if hormonal causes are suspected.

Regarding diabetes medication, if there is strong temporal association between Ozempic initiation and ED onset, your diabetes specialist may consider alternative glucose-lowering therapies as part of shared decision-making. Other options include SGLT2 inhibitors, DPP-4 inhibitors, or traditional agents such as metformin. However, any medication change must be carefully balanced against glycaemic control and cardiovascular benefits, particularly as there is no established causal link between semaglutide and ED. GLP-1 receptor agonists as a class have demonstrated cardiovascular protection in clinical trials, which is particularly valuable in type 2 diabetes.

You should contact your GP promptly if:

• Erectile dysfunction develops suddenly or worsens rapidly

• You experience chest pain, breathlessness, or palpitations during sexual activity

• ED is accompanied by reduced libido, fatigue, or mood changes (suggesting possible hormonal issues)

• You have concerns about your diabetes control or medication side effects

• The condition is causing significant psychological distress or relationship difficulties

Remember that erectile dysfunction is a common, treatable condition, and discussing it with healthcare professionals is an important step towards effective management. The NHS provides confidential support, and addressing ED may also identify other cardiovascular risk factors requiring attention, ultimately contributing to better overall health outcomes.

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