Back to 2026 Abstracts
GLP-1 Receptor Agonist Addition to Testosterone Replacement Therapy is Associated with Reduced Erectile Dysfunction: A Propensity-Matched Analysis
Samuel Z. Lee, BA1, Winston Tan, BS1, Nancy Donohoo, BS1, Lori Lerner, MD2, Rachel Greenberg, MD2.
1Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA, 2VA Boston Healthcare System, Department of Surgery, West Roxbury, MA, USA.
Intro: Metabolic syndrome and sexual dysfunction are common comorbidities in males with obesity. Although the standard treatment for hypogonadism is testosterone replacement therapy (TRT), the effect of concurrent GLP-1 receptor agonist therapy on sexual function is not well studied.
Methods: We queried the TriNetX Research Network for obese and hypogonadal men aged 40 to 75 years receiving TRT alone or in combination with a GLP-1 receptor agonist. Individuals were propensity score matched in a 1:1 ratio based on patient demographics, relevant comorbidities, baseline laboratory values, and medication exposures. We fit Cox proportional hazards models to assess the association of GLP-1 addition with metabolic markers (LDL, HDL), as well as incident erectile dysfunction, infertility, low libido, and ejaculatory dysfunction within 5 years of therapy initiation.
Results: After propensity score matching, 11,931 individuals remained for analysis in each cohort (
Table 1). Post-exposure testosterone levels did not differ significantly between cohorts (419.63±305.63 vs 430.55±331.86 ng/dL,
p=0.069) (
Table 2). The addition of GLP-1 was significantly associated with lower rates of post-exposure ED (HR 0.880; 95% CI 0.809-0.957), but was insignificant for infertility (HR 0.750; 95% CI 0.443-1.270), low libido (HR 1.093; 95% CI 0.914-1.307), and ejaculatory dysfunction (HR 1.268; 95% CI 0.921-1.746).
Conclusion: Despite similar post-treatment testosterone levels, the addition of GLP-1 receptor agonists to TRT is associated with improved erectile function, suggesting benefit beyond androgen optimization.
Back to 2026 Abstracts
