GLP-1s and Men’s Health: A Surprising Connection Worth Understanding

In the growing conversation around GLP-1 receptor agonists – medications widely used to treat type 2 diabetes and support weight loss – the attention usually centers on women. But as more men begin to turn to GLP-1s for metabolic health, it’s important to talk about a lesser-known topic: how these medications may impact male reproductive and hormonal health.

In this installment of our GLP-1 series, we’re spotlighting the ways GLP-1s may support not just weight loss and blood sugar regulation, but testosterone levels, fertility, and overall reproductive function in men.

The Link Between Weight, Hormones, and Fertility in Men

When it comes to men’s health, weight plays a bigger role than many people realize – especially when it comes to hormones and fertility. Extra body fat can cause the body to produce more estrogen and less testosterone, throwing off the balance of key reproductive hormones. This imbalance can disrupt the HPG axis – short for the hypothalamic-pituitary-gonadal axis – which links the brain and testes to regulate testosterone levels and sperm production.

On top of that, insulin resistance and chronic inflammation, both common with obesity, can make things worse by reducing sperm quality and further lowering testosterone. This pattern, often called obesity-related hypogonadism, can lead to symptoms like fatigue, low libido, and infertility. The encouraging news is that dealing with the underlying metabolic issues can help, and that’s where GLP-1 medications may offer support.

How GLP-1s May Help Men Reclaim Their Hormonal Health

According to a 2023 narrative review in Medicina (Kaunas), GLP-1 receptor agonists have shown promising benefits for obese men struggling with fertility. While originally developed to help manage type 2 diabetes, GLP-1s may support male reproductive health in several ways:

• Healthier Sperm: Losing weight with the help of GLP-1s has been linked to improvements in sperm count, movement, and overall quality.
• Better Blood Sugar, Better Hormones: When blood sugar is more stable, the testes tend to function better. That means more support for natural testosterone production.
• Less Inflammation: Chronic inflammation can interfere with hormone production. By reducing inflammation, GLP-1s may help the body do a better job producing testosterone.
• Lower Estrogen Levels: Men with more body fat often have higher estrogen due to an enzyme that turns testosterone into estrogen. By cutting down on that fat, GLP-1s may help bring hormone levels back into balance.
• Improved Sleep: Poor sleep, especially from sleep apnea, can throw off hormone production. Weight loss from GLP-1s may ease those symptoms and support healthier testosterone levels through better rest.

A Metabolic Win with Reproductive Perks

As interest in these medications grows, many men have concerns about how GLP-1 therapy might impact their fertility, hormone levels, and sexual health. Ryan Norton, Pharm.D., AAHIVP, Clinical Pharmacy Specialist at Legacy, notes that questions around testosterone, sperm health, and reproductive function are common among male patients considering or starting this treatment.

“These are valid and understandable concerns,” Ryan explains. “While GLP-1s are not FDA-approved to treat hormone imbalance or infertility, the weight loss they promote can actually help improve reproductive health. So far, studies have not shown negative effects on sperm count or erectile function.”

Dr. Gerti Tashko, a board-certified endocrinologist, notes that many men using GLP-1s see a natural rebound in testosterone without the need for direct hormone therapy. In fact, research cited by GT Health found that even a 10% reduction in body weight via GLP-1 therapy significantly increased testosterone levels.

The Medicina review concluded that while more long-term clinical studies are needed, early data suggest GLP-1s may be a non-invasive option for obese men experiencing infertility. So far, no adverse reproductive effects have been observed, and the potential benefits are encouraging.

It’s also worth noting that these medications carry some known side effects, such as gastrointestinal discomfort and potential strain on the kidneys, but reproductive harm has not been documented.

What This Means for Our Patients at Legacy

At Legacy Community Health, we’re committed to whole-person care – helping patients manage chronic conditions while also supporting their long-term health goals. GLP-1 medications are a powerful example, offering benefits beyond blood sugar control.

According to Ryan, these therapies have helped many men feel more confident, energized, and motivated to prioritize preventive care. “GLP-1s support overall cardiometabolic health and help reduce the risk of conditions like heart disease and sleep apnea before they develop,” he explains.

Access, however, remains a challenge. “The greatest barrier is cost – even for insured patients, out-of-pocket expenses can be high,” says Ryan. Currently, Legacy can only offer GLP-1 therapy for weight loss to insured patients or patients willing to pay the monthly cash price starting at $500 per month. Unfortunately, there are no prescription assistance programs for GLP-1s indicated for weight loss.

Your Support Team for GLP-1 Success

To ensure safe and effective use, Legacy pharmacists provide personalized counseling on dosing, side effects, and expectations. One-on-one consultations with clinical pharmacy specialists are also available. In addition, our team works closely with nutrition services and the Body Positive program to offer ongoing support throughout each patient’s weight loss journey.

As new therapies become available, Legacy’s pharmacy team is always looking for ways to make them more accessible and effective for our patients. If you’re interested in learning how GLP-1 treatments might fit into your health journey, visit legacycommunityhealth.org.