02 Jul ENDO 2026: GLP-1 Receptor Agonists May Improve Testosterone Parameters in Obese Men With Hypogonadism Without Suppressing Male Reproductive Axis
MedicalResearch.com Interview with:
Pratibha Natesh, MBBS MRCP MRes
Consultant
University Hospitals Coventry and Warwickshire
Coventry, United Kingdom
Jiran Muhammed
Jiran Muhammad
Medical Student and Researcher
Warwick Medical School
Coventry, United Kingdom
Haziq Abedi
Haziq Abedi
Medical Student and Researcher
Warwick Medical School
Coventry, United Kingdom
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The use of GLP-1 receptor agonists (GLP-1 RAs) has increased rapidly in recent years, largely due to their role in weight loss as well as their established benefits in type 2 diabetes. Their use in obesity is a relatively newer indication, which means there is significant scope for further research into their wider effects.
Obesity is also strongly linked with male reproductive dysfunction, including lower testosterone, altered gonadotrophin levels, and poorer semen parameters. We therefore wanted to assess whether GLP-1 RAs affect the male HPG axis.
In our review, we searched PubMed and Cochrane up to October 2025 and included five RCTs, with three studies providing data suitable for quantitative analysis. We also discussed a sixth RCT as supportive secondary evidence, as it did not measure our primary outcomes but provided relevant data for our secondary outcomes.
In healthy men, the findings were reassuring. In a four week dulaglutide trial 24 of 26 participants completed the study and dulaglutide did not significantly affect sexual function, testosterone, LH, FSH or semen parameters.
In men with obesity related reproductive dysfunction, the findings were more suggestive of potential benefit. In one 16 week liraglutide study of obese men with functional hypogonadism, total testosterone increased by approximately 34% from baseline, alongside weight loss and improvements in LH and FSH. In a 24 week semaglutide trial of men with obesity, type 2 diabetes and functional hypogonadism, morphologically normal sperm improved from 2% to 4%, while total testosterone increased by approximately 28% from baseline whilst LH and FSH remained relatively stable.
Overall, these findings suggest that GLP-1 RAs do not appear to suppress the male reproductive axis in healthy men. Any improvements seen in obese hypogonadal men are likely to be related largely to weight loss and improved metabolic health, rather than a clearly proven direct effect of GLP-1 RAs on the reproductive axis. However, further studies are needed to confirm this.
MedicalResearch.com: Would a patient have to be obese for this effect to occur?
Response: The beneficial effects shown in the available data appear to be most relevant to men with obesity related reproductive dysfunction, particularly functional hypogonadism. This includes evidence from obese men with functional hypogonadism, some of whom had type 2 diabetes, as well as a separate semaglutide study specifically in men with obesity, type 2 diabetes, and functional hypogonadism. As it is well documented, obesity is associated with several metabolic disturbances, and disruption of reproductive hormones is one of them.
In the studies involving healthy men who were not obese, GLP-1 RAs did not appear to have a meaningful impact on reproductive hormones. However, the evidence is not strong enough to conclude that only men with obesity may benefit, or that GLP-1 RAs have no reproductive effect at all in healthy men.
MedicalResearch.com: What should readers take away from your report?
Response: The key message is that current evidence is reassuring but limited. GLP-1 RAs do not appear to harm male reproductive hormones or semen quality based on the available data.
In men with obesity related hypogonadism, GLP-1 RA treatment may be associated with improvements in reproductive hormone parameters and some semen outcomes. However, the current evidence base is small, so more robust fertility focused studies are needed before firm conclusions can be made.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should include larger and longer RCTs designed to focus on male reproductive outcomes.
Studies should measure testosterone, LH, FSH, SHBG, semen parameters, and sexual function. It would also be beneficial to separate the direct effects of GLP-1 RAs from the indirect effects of weight loss and improved metabolic health.
MedicalResearch.com: Is there anything else you would like to add? Any disclosures?
Response: The authors, Jiran Muhammad, Haziq Abedi, supervising author and principal investigator Dr. Pratibha Natesh declare no conflicts of interest. The views expressed are those of the authors.
We are grateful for Dr. Natesh’s guidance and support throughout the project.
For more on GLP-1 research and metabolic health, see MedicalResearch.com’s diabetes and metabolic health research coverage.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, obesity is associated with a range of hormonal disruptions including hypogonadism in men, making the intersection of weight management therapies and reproductive health an increasingly important area of clinical research.
Citation:
Muhammad J, Abedi H, Natesh P. Effect of Glucagon Like Peptide-1 Agonist on Hypothalamo-Pituitary-Gonadal Axis in Males. ENDO 2026, June 2026. @TheEndoSociety
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Last Updated on July 2, 2026 by Marie Benz MD FAAD