Effects of glucagon-like peptide-1 receptor agonists on male reproductive hormones, semen parameters, and metabolic outcomes: a systematic review
Abstract
INTRODUCTION: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are antidiabetic agents that also induce weight loss. Their widespread use has prompted investigation of potential benefits beyond glycemic control, including effects on male sexual and reproductive function. Emerging evidence suggests that they may improve male reproductive parameters, particularly in men with metabolic dysfunction.
OBJECTIVES: To systematically evaluate the effects of GLP-1RAs (liraglutide, semaglutide, dulaglutide, and exenatide) on male reproductive hormones, semen parameters, and metabolic outcomes.
METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched in PubMed, Embase, Scopus, and Web of Science up to April 2025. Eligible studies included randomized controlled trials (RCTs) and cohort studies evaluating the effects of GLP-1RAs in adult men. Assessed the risk of bias with the risk of bias 2 tool for RCT and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool for observational studies.
RESULTS: Ten studies involving a total of 639 men were included. GLP-1RAs were consistently associated with increased total testosterone, particularly in men with obesity, type 2 diabetes, or functional hypogonadism. Free testosterone changes were inconsistent, often offset by concurrent rises in sex hormone-binding globulin. Luteinizing hormone and follicle-stimulating hormone levels were…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 639 participants or records.
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