Liraglutide and Sexual Function: What the Evidence Actually Shows

Saxenda and Victoza are separate products

Saxenda is approved for weight management, while Victoza is approved to improve blood-sugar control in type 2 diabetes and reduce certain cardiovascular risks in adults with type 2 diabetes and established cardiovascular disease [1][2]. Both are injected subcutaneously once daily [1][2]. FDA-approved generics of both reference products exist [6]. Victoza is not approved for weight loss, and Saxenda is not indicated for glycemic control in type 2 diabetes [1][2].

What the labels say

Sexual dysfunction does not appear in the adverse-reaction tables of either label, and it is not an indication for either product [1][2]. The Saxenda warnings and precautions run from thyroid C-cell tumors through pulmonary aspiration with no sexual-function item among them [1].

Mood is the closest related topic either label addresses. In the 56-week adolescent trial, depression was reported in 4% of liraglutide-treated patients versus 2.4% on placebo [1]. In January 2026 the FDA asked the makers of Saxenda, Wegovy and Zepbound to remove the suicidal ideation and behavior warning from their labels after a review that included a meta-analysis of 91 placebo-controlled GLP-1 trials (107,910 patients) and a claims cohort of 2,243,138 new users; the agency said it found no increased risk [7]. The current Saxenda label no longer contains that warning [1].

What the liraglutide trials measured

The large liraglutide trials reported body weight, BMI, HbA1c and cardiovascular events [3][8][9][10][11]. Libido, erectile function and questionnaire scores such as the IIEF or FSFI were not among the outcomes described. Any link through weight, blood-sugar control or mood therefore remains untested in liraglutide trials.

The indirect route in men: weight and testosterone

SCALE Obesity randomized 3,731 adults without diabetes and with a BMI of 30 or higher (27 or higher with dyslipidemia or hypertension) to liraglutide 3.0 mg (n=2,487) or placebo (n=1,244) plus lifestyle counseling for 56 weeks. Mean weight fell 8.4 kg with liraglutide and 2.8 kg with placebo, a difference of 5.6 kg; 63.2% versus 27.1% lost at least 5% of body weight and 33.1% versus 10.6% lost more than 10% [3]. In adults with type 2 diabetes, SCALE Diabetes reported 6.0% weight loss at 3.0 mg versus 2.0% on placebo over 56 weeks [8].

The testosterone evidence comes from a different literature. A meta-analysis of 24 studies of diet or bariatric surgery found a significant rise in total testosterone with both, larger with bariatric surgery (increase 8.73 versus 2.87 with a low-calorie diet), with estradiol falling and gonadotropins rising; the degree of weight loss was the best determinant of the testosterone rise [4]. The liraglutide trials did not report testosterone.

Erectile dysfunction and type 2 diabetes

The Massachusetts Male Aging Study, a community sample of men aged 40 to 70, found a combined prevalence of minimal, moderate and complete impotence of 52%, with complete impotence tripling from 5% to 15% between ages 40 and 70. After adjustment for age, a higher probability of impotence correlated with heart disease, hypertension and diabetes [12].

Liraglutide trials in type 2 diabetes measured blood sugar and cardiovascular events. In LEAD-6, liraglutide 1.8 mg lowered HbA1c by 1.12 percentage points at 26 weeks versus 0.79 with exenatide (233 and 231 patients) [5]. In LEADER, 9,340 adults with type 2 diabetes and high cardiovascular risk had a first major cardiovascular event in 13.0% of the liraglutide group versus 14.9% on placebo over a median 3.8 years, hazard ratio 0.87 [11]. Erectile function was not measured in those trials.

Women: PCOS, obesity and sexual function

PCOS affects 5% to 20% of women of reproductive age, and insulin resistance with compensatory hyperinsulinemia is present in the vast majority [13]. The liraglutide data in this group are metabolic. A six-month case-control study recruited 19 women with PCOS and 17 weight-matched controls to take liraglutide 1.8 mg daily; 13 and 12, respectively, completed it. Weight fell 3.0 kg in the PCOS group, and the liver fibrosis marker PIIINP fell significantly; sexual function was not assessed [14].

The link between obesity and sexual function in women is unclear. In a study of 45 obese or overweight women and 30 age-matched controls, total FSFI scores were 22.1 versus 23.1, not significantly different (P=0.74). Eighty-six percent of the obese women and 83% of controls scored in the dysfunction range, and BMI correlated negatively with the orgasm and satisfaction domains but FSFI scores overall were not correlated with body measurements [15]. That study did not test liraglutide or any other treatment.

Common reactions in the label trials

The Saxenda adult trials (3,384 treated versus 1,941 on placebo, up to 56 weeks at 3 mg) recorded nausea in 39.3% versus 13.8%, diarrhea in 20.9% versus 9.9%, constipation in 19.4% versus 8.5%, fatigue in 7.5% versus 4.6% and dizziness in 6.9% versus 5%; 9.8% versus 4.3% stopped treatment because of adverse reactions [1]. In Victoza trials, nausea at 1.8 mg was 20% versus 5% on placebo [2]. These figures do not show whether liraglutide changes libido, and reduced libido is not among the reactions tabulated in either label [1][2].

Contraception and pregnancy

In the Saxenda label's oral contraceptive study (0.03 mg ethinylestradiol with 0.15 mg levonorgestrel), liraglutide lowered the peak concentration of ethinylestradiol by 12% and of levonorgestrel by 13%, with no effect on ethinylestradiol AUC and an 18% increase in levonorgestrel AUC; the label gives no instruction to switch or add contraception [1]. The Saxenda label says weight loss offers no benefit during pregnancy, describes potential fetal risk, says Saxenda should be used in pregnancy only if the potential benefit justifies the risk to the fetus, and says to discontinue Saxenda when pregnancy is recognized [1].