Wegovy (semaglutide 2.4 mg) is a once-weekly injectable GLP-1 receptor agonist licensed in the UK for weight management in adults with obesity or overweight with weight-related comorbidities. Whilst Wegovy is effective for weight reduction when used alongside lifestyle changes, some patients wonder whether it might affect libido or sexual function. Currently, there is no established clinical evidence linking Wegovy directly to changes in sexual desire. However, weight loss itself—regardless of method—can influence sexual health through hormonal, cardiovascular, and psychological pathways. This article examines the relationship between Wegovy and libido, explores how weight loss may impact sexual function, and provides guidance on what to do if you experience any concerns during treatment.
Quick Answer: There is no established clinical evidence that Wegovy (semaglutide) directly affects libido or sexual function.
Wegovy (semaglutide 2.4 mg) is a prescription medicine licensed in the UK for weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with at least one weight-related comorbidity, such as type 2 diabetes, hypertension, or obstructive sleep apnoea. It is administered as a once-weekly subcutaneous injection and is intended to be used alongside a reduced-calorie diet and increased physical activity.
While this is the licensed indication, it's important to note that NICE guidance (TA875) recommends more specific criteria for NHS use: typically for people with a BMI ≥35 kg/m² (lower thresholds may apply for some ethnic groups) with at least one weight-related comorbidity, prescribed within specialist weight management services, and limited to a maximum treatment duration of 2 years.
Semaglutide belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs mimic the action of GLP-1, a naturally occurring hormone released by the intestine in response to food intake. GLP-1 receptor agonists work through several mechanisms to promote weight loss:
Appetite suppression: Semaglutide acts on receptors in the brain's appetite centres, particularly the hypothalamus, reducing feelings of hunger and increasing satiety after meals.
Delayed gastric emptying: The medication slows the rate at which food leaves the stomach, prolonging the sensation of fullness.
Improved glycaemic control: In individuals with type 2 diabetes, semaglutide enhances insulin secretion in a glucose-dependent manner and suppresses inappropriate glucagon release.
Treatment begins with a dose-titration schedule (0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg weekly) to minimise gastrointestinal side effects. Some patients may remain on 1.7 mg if the 2.4 mg dose is not tolerated. For patients with type 2 diabetes, there is an increased risk of hypoglycaemia when Wegovy is used with insulin or sulfonylureas, and doses of these medications may need adjustment.
Clinical trials have demonstrated that Wegovy can lead to significant weight reduction—typically 10–15% of initial body weight over 68 weeks when combined with lifestyle modifications. Treatment should be discontinued if insufficient weight loss is achieved according to criteria specified in the Summary of Product Characteristics and NICE guidance.
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Start HereThere is currently no official, established link between Wegovy (semaglutide) and changes in libido or sexual function based on the drug's Summary of Product Characteristics or major clinical trial data. Sexual dysfunction is not listed among the common or uncommon adverse effects in the prescribing information approved by regulatory authorities. The most frequently reported side effects of Wegovy are gastrointestinal in nature, including nausea, vomiting, diarrhoea, constipation, and abdominal pain.
However, it is important to recognise that weight loss itself—regardless of the method—can influence sexual health and libido through multiple pathways. Some individuals report improvements in sexual function following significant weight reduction due to enhanced self-esteem, improved cardiovascular fitness, better hormonal balance, and reduced inflammation. Conversely, others may experience temporary changes during the active weight loss phase.
Anecdotal reports from patients taking GLP-1 receptor agonists have occasionally mentioned changes in sexual desire, but these accounts are not substantiated by robust clinical evidence and causality remains unproven. It remains unclear whether such experiences are directly attributable to the medication, the physiological stress of rapid weight loss, psychological factors, or pre-existing conditions.
Potential indirect mechanisms that could theoretically influence libido include:
Nutritional deficiencies if caloric restriction is excessive
Fatigue or low energy during the initial treatment phase
Hormonal fluctuations associated with adipose tissue loss
Psychological adjustment to body image changes
Patients should be reassured that sexual side effects are not a recognised feature of Wegovy therapy, but any persistent concerns warrant clinical evaluation to exclude other contributing factors. If you experience any suspected side effects while taking Wegovy, you should report them to the MHRA through the Yellow Card scheme.
While Wegovy itself is not known to directly affect libido, the broader context of weight loss—whether achieved through medication, diet, exercise, or surgery—can have complex effects on sexual health. Understanding these mechanisms helps patients and clinicians contextualise any changes that may occur during treatment.
Hormonal changes are among the most significant factors. Adipose (fat) tissue is metabolically active and plays a role in hormone production and metabolism. In individuals with obesity, excess fat can lead to:
Altered sex hormone levels: Increased aromatisation of androgens to oestrogens in adipose tissue, potentially affecting testosterone levels in both men and women
Insulin resistance: Which may impair endothelial function and reduce blood flow necessary for sexual arousal
Elevated inflammatory markers: Chronic low-grade inflammation associated with obesity can negatively impact vascular and sexual health
As weight decreases, these parameters often improve. Many patients experience enhanced sexual function following weight loss due to improved cardiovascular health, increased energy levels, better mobility, and enhanced self-confidence. Research suggests that modest weight reduction (5–10% of body weight) can improve erectile function in men and sexual satisfaction in women.
However, rapid or substantial weight loss may temporarily disrupt hormonal equilibrium. The body may interpret significant caloric restriction as a stressor, potentially affecting reproductive hormones and libido. In women, this may occasionally manifest as menstrual irregularities. Additionally, psychological factors—such as adjusting to a new body image, relationship dynamics, or the emotional demands of lifestyle change—can influence sexual desire.
Nutritional adequacy is also crucial. Severe caloric restriction without proper nutritional balance may lead to deficiencies in vitamins and minerals (such as zinc, vitamin D, and B vitamins) that support sexual health and energy levels. Patients using Wegovy should follow a balanced, nutrient-dense diet in line with NHS healthy eating guidelines, and healthcare professionals may consider checking micronutrient levels if deficiency symptoms develop.
If you notice changes in your libido or sexual function while taking Wegovy, it is important to approach the situation methodically and seek appropriate medical advice. Here are recommended steps:
1. Document your symptoms: Keep a record of when changes began, their severity, and any other accompanying symptoms (fatigue, mood changes, gastrointestinal issues). This information will help your GP or specialist assess the situation more accurately.
2. Do not stop Wegovy abruptly without medical advice: While it may be tempting to discontinue the medication if you suspect it is causing problems, there is no established evidence linking Wegovy to sexual dysfunction. Stopping treatment without consultation may compromise your weight management goals unnecessarily.
3. Consult your GP or prescribing clinician: Discuss your concerns openly. Your doctor can:
Review your medication history for other drugs that may affect libido (such as antidepressants, antihypertensives, or hormonal treatments)
Assess for underlying conditions (thyroid disorders, diabetes complications, cardiovascular disease, depression, or anxiety)
Arrange appropriate investigations, which may include blood tests for hormones and metabolic parameters. For men, this typically includes two early-morning total testosterone measurements on separate days, and possibly prolactin, thyroid function, fasting glucose/HbA1c, and lipids. For women, evaluation may include menstrual history and endocrine tests if indicated.
4. Evaluate lifestyle factors: Consider whether stress, sleep quality, relationship issues, or excessive caloric restriction might be contributing. Adequate sleep, stress management, and maintaining a balanced diet are essential for sexual health.
5. Consider specialist referral if needed: If initial assessment does not identify a clear cause, your GP may refer you to an endocrinologist, NHS sexual health service, or psychosexual therapy for further evaluation.
Important considerations regarding pregnancy: Wegovy should not be used during pregnancy or breastfeeding. If you are of childbearing potential, effective contraception is recommended during treatment. If you become pregnant while taking Wegovy, the medication should be discontinued immediately. Discuss any plans for conception with your prescribing clinician.
When to seek urgent advice: Contact your healthcare provider promptly if you experience:
Severe, persistent abdominal pain (with or without vomiting), which could indicate pancreatitis
Chest pain or exertional symptoms alongside erectile dysfunction, which may suggest cardiovascular disease
Significant mood changes or suicidal thoughts
Severe fatigue or other concerning symptoms alongside changes in libido, as these may indicate an underlying condition requiring immediate investigation.
No, sexual dysfunction is not listed as a recognised side effect of Wegovy in the Summary of Product Characteristics or major clinical trials. The most common adverse effects are gastrointestinal, including nausea, vomiting, and diarrhoea.
Yes, weight loss may improve sexual function through enhanced cardiovascular health, better hormonal balance, increased energy, and improved self-confidence. Research suggests that modest weight reduction can improve erectile function in men and sexual satisfaction in women.
Consult your GP or prescribing clinician without stopping Wegovy abruptly. Your doctor can assess for other causes such as concurrent medications, underlying conditions, or lifestyle factors, and arrange appropriate investigations if needed.
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