Start your personalized transformation with a free consult!

GLP-1 Therapy for Men: Benefits, Risks, and Hormone Considerations 

Man improving metabolic health with GLP-1 therapy, supporting testosterone, muscle preservation, and weight loss
Posted in Weight Loss

GLP-1 Therapy for Men: Benefits, Risks, and Hormone Considerations 

by

GLP-1 medications have become some of the most widely discussed treatments for weight loss and type 2 diabetes. Much of the public focus has been on women’s experiences with these therapies, but men are increasingly turning to GLP-1 medications for help with weight management and overall health. 

For men, the questions often go beyond body fat reduction. Many are concerned about how GLP-1 therapy could affect testosterone, fertility, muscle preservation, and sexual health. Others want clarity on whether these medications are safe for long-term use.

At Ivim Health, our GLP-1 ID program offers an individualized approach to treatment, giving men the ability to achieve weight loss while optimizing long-term health, strength, and hormone balance.

Obesity and Men’s Health: Why It Matters

Carrying excess weight affects nearly every system in the body. Obesity is not only a matter of appearance but a driver of conditions that reduce quality of life and longevity.

For men, obesity may be associated with:

  • Metabolic conditions, including type 2 diabetes, insulin resistance, and hypertension 

When men lose excess weight, they often see improvements in testosterone levels. This hormonal restoration can lead to better energy levels, enhanced fertility potential, and an overall improvement in vitality and well-being. 

Weight loss creates a positive cycle: as hormones return to healthier levels, men may begin to experience renewed energy and motivation, which supports long-term health and quality of life.

What Are GLP-1 Medications and How Do They Work?

GLP-1 stands for glucagon-like peptide-1, a hormone released after eating that helps regulate appetite, digestion, and blood sugar. GLP-1 receptor agonist medications mimic this hormone’s effects, leading to slower stomach emptying, better insulin sensitivity, and reduced hunger.

GLP-1 clinical trials have demonstrated significant weight loss outcomes. In the STEP trials for semaglutide and the SURMOUNT trials for tirzepatide, participants achieved substantial weight loss that far exceeded what most people accomplish through diet and exercise alone. 

For men, these medications deliver benefits that go well beyond weight reduction. By improving insulin sensitivity and reducing inflammation throughout the body, GLP-1 therapy creates the foundation for better hormone balance and testosterone levels, enhanced cardiovascular health, and improved reproductive function.

GLP-1 for Men: Weight Loss Outcomes

One of the clearest benefits of GLP-1 therapy is consistent and significant weight loss. Studies show that individuals on semaglutide often lose around 15 percent of their starting weight, while tirzepatide can lead to reductions of 20 percent or more. With the IVIM approach, patients on semaglutide have achieved even better results. This level of weight loss can improve metabolic health and reduce risks tied to obesity.

Benefits of weight loss include:

  • Decreasing visceral fat, the type of fat that accumulates around internal organs and is especially harmful to men’s cardiovascular health 
  • Improved sleep quality due to reductions in sleep apnea severity

A common question for men is whether weight loss on GLP-1 medications also means losing muscle. While muscle preservation is a valid concern with any weight loss approach, preliminary research shows that combining proper nutrition with resistance training can effectively maintain muscle mass during GLP-1 therapy.

GLP-1 and Muscle Preservation in Men

Muscle health is a top concern for many men considering GLP-1 therapy. Muscle mass plays a critical role in regulating strength and overall metabolic health, and testosterone is essential for muscle protein synthesis and maintaining muscle mass, making preservation during weight loss essential for men. 

Below are some evidence-based strategies:

  • Adequate nutrition and protein intake: Sufficient nutrition and dietary protein should be a priority to help preserve muscle mass, particularly in combination with a structured strength training program. Focus on consuming protein throughout the day to support muscle maintenance. 
  • Resistance training: Structured strength and resistance training can help preserve lean mass during weight reduction. Strength training and multi-joint exercises help stimulate the production of proteins.
  • Nutritional support: Amino acids are key drivers of muscle protein synthesis. When combined with exercise and adequate protein intake, amino acids can help support lean muscle and post-exercise recovery, even during periods of weight loss.
  • Recovery and sleep: Testosterone levels typically increase during sleep as part of a natural rhythm, with sleep facilitating normal testosterone production. Quality sleep supports muscle recovery. When sleep is lacking, cortisol rises and testosterone drops, making it harder for the body to rebuild muscle.

When combined with GLP-1 therapy under proper medical supervision, these practices help ensure that patients can preserve muscle mass, allowing men to lose primarily fat while preserving strength and metabolic health. 

Targeted nutritional support, including adequate protein intake and amino acids, plays a crucial role in this muscle preservation strategy. Strategic supplementation may help with recovery and protect against muscle breakdown while your body undergoes weight loss.

GLP-1 and Testosterone: What the Research Shows

A key question is whether GLP-1 medications lower testosterone. Current research provides reassurance: 

  • No evidence shows that GLP-1 therapy directly reduces testosterone levels. Recent research shows that men treated with GLP-1-based weight loss therapies, such as semaglutide and tirzepatide, experienced significant increases in both total and free testosterone levels. Studies comparing semaglutide to testosterone replacement therapy found that both treatments resulted in significant increases in total testosterone.
  • GLP-1–related weight loss may improve testosterone levels. This is because extra fat tissue produces an enzyme (aromatase) that turns testosterone into estrogen, which can leave men with lower testosterone. Both moderate and significant reductions in BMI are associated with notable increases in serum testosterone levels, along with improvements in insulin sensitivity.
  • Better metabolic health can reduce inflammation, further supporting hormonal stability. When you carry extra weight, your fat cells release chemicals that cause mild but constant inflammation in your body, and some of these chemicals can harm the organs responsible for making testosterone.

GLP-1 and Male Fertility

Research specifically linking GLP-1 medications to sperm health is limited. However, what is well established is that overweight and/or obesity are strongly associated with male infertility in several overlapping ways.

Excess weight can disrupt hormones linked to fertility, increase the risk for defective sperm, adversely affect semen quality, and even make sexual intercourse more difficult due to obesity’s link to erectile dysfunction. The accumulation of excess fat leads to elevated estrogen levels and diminished testosterone levels, disrupting sperm production and quality. 

Because GLP-1 therapy helps men lose weight and improve their overall health, experts say the connection between GLP-1 medications and improved male fertility makes sense from a medical standpoint. 

A study comparing semaglutide to testosterone replacement therapy found that semaglutide was better at improving weight and muscle composition while keeping sperm quality healthy. 

Men who want to start a family get the best results when they combine these medications with healthy habits, staying active, eating nutritious foods, and managing stress. GLP-1 therapy isn’t designed as a fertility treatment, but by helping men get healthier overall, it may naturally improve their ability to conceive.

GLP-1 and Sexual Health (ED, Libido)

Another frequent concern among men is how GLP-1 medications might affect their sexual performance. Given that these drugs can influence weight, hormones, and overall health, it’s natural to wonder if they could cause erectile dysfunction or lower libido. Fortunately, the evidence is generally reassuring: 

Through weight loss, GLP1 medications can help support higher testosterone levels and better metabolic function, which in turn support improved sexual performance.

GLP-1 Safety and Choosing the Right Option for Men

The most common side effects with GLP-1 medications are gastrointestinal, such as nausea, bloating, constipation, or diarrhea, which are typically mild and improve as the body adjusts over time. 

Semaglutide vs. Tirzepatide: Which Is Better? 
A frequent question men ask is which medication delivers better results for weight loss. Both options are highly effective, but there are key distinctions:

  • Semaglutide: One of the most extensively studied GLP-1 medications, widely available, and proven effective for both type 2 diabetes management and significant weight loss. 
  • Tirzepatide: A newer medication that acts on both GLP-1 and GIP receptors. Clinical trials indicate it may produce greater weight loss than semaglutide, with additional metabolic benefits.

The right choice ultimately depends on your goals, individual response and how well you tolerate side effects, something best discussed with your provider to find the most suitable option. Through Ivim Health’s GLP-1 ID program, men can access either semaglutide or tirzepatide with flexible dosing and personalized provider support.

GLP-1 Medication and Men: Bringing it All Together

GLP-1 medications are more than weight loss tools for men. They support fat reduction, healthier testosterone levels, improved fertility potential, and better sexual function. When paired with strength training, proper nutrition, and targeted supplements, men can achieve lasting improvements in health and performance. 

Ivim Health’s GLP-1 ID program provides flexible options with semaglutide and tirzepatide, individualized dosing, and ongoing provider support tailored to men’s needs. 

Reviewed by Emily Bigby, MD, Physician with Ivím Health

Disclaimer:  

This content is for informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider before making decisions about hormone therapy or related treatments.

Sources:

Busebee, Bradley, et al. “Obesity: A Review of Pathophysiology and Classification.” Mayo Clinic Proceedings, vol. 98, no. 12, Dec. 2023, pp. 1842-1857, https://pubmed.ncbi.nlm.nih.gov/37831039/. 

Stephenson, J., et al. “The Association between Obesity and Quality of Life: A Retrospective Analysis of a Large-Scale Population-Based Cohort Study.” BMC Public Health, vol. 21, article 1990, 3 Nov. 2021, https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-12009-8. 

Ng Tang Fui, Mark, et al. “Effects of Testosterone Treatment on Body Fat and Lean Mass in Obese Men on a Hypocaloric Diet: A Randomised Controlled Trial.” BMC Medicine, vol. 14, article 153, 7 Oct. 2016, https://doi.org/10.1186/s12916-016-0700-9. 

Ameratunga, Devini, et al. “Obesity and Male Infertility.” Best Practice & Research Clinical Obstetrics & Gynaecology, vol. 90, Aug. 2023, 102393, https://doi.org/10.1016/j.bpobgyn.2023.102393. 

Liu, Yixun, et al. “Association of BMI with Erectile Dysfunction: A Cross-Sectional Study of Men from an Andrology Clinic.” Frontiers in Endocrinology, vol. 14, 29 Mar. 2023, https://doi.org/10.3389/fendo.2023.1135024. 

Drager, Luciano F., et al. “Obstructive Sleep Apnea: A Cardiometabolic Risk in Obesity and the Metabolic Syndrome.” Journal of the American College of Cardiology, vol. 62, no. 7, 12 June 2013, https://doi.org/10.1016/j.jacc.2013.05.045. 

Okobi, Okelue E., et al. “Impact of Weight Loss on Testosterone Levels: A Review of BMI and Testosterone.” Cureus, vol. 16, no. 12, 21 Dec. 2024, e76139, https://doi.org/10.7759/cureus.76139. 

Santi, Daniele, et al. “Weight Loss as Therapeutic Option to Restore Fertility in Obese Men: A Meta-Analytic Study.” World Journal of Men’s Health, vol. 43, no. 2, Apr. 2025, pp. 333-343, https://pubmed.ncbi.nlm.nih.gov/39344112/. 

Collins, Logan, and Ryan A. Costello. “Glucagon-Like Peptide-1 Receptor Agonists.” NCBI Bookshelf, 29 Feb. 2024, https://www.ncbi.nlm.nih.gov/books/NBK551568/. 

Zheng, Zhikai, et al. “Glucagon-like Peptide-1 Receptor: Mechanisms and Advances in Therapy.” Signal Transduction and Targeted Therapy, vol. 9, article 234, 18 Sept. 2024, https://doi.org/10.1038/s41392-024-01931-z. 

Bergmann, Natasha Chidekel, et al. “Semaglutide for the Treatment of Overweight and Obesity: A Review.” Diabetes, Obesity & Metabolism, vol. 25, no. 1, 18 Oct. 2022, pp. 18-35, https://doi.org/10.1111/dom.14863. 

Jastreboff, Ania M., et al. “Tirzepatide Once Weekly for the Treatment of Obesity.” New England Journal of Medicine, 4 June 2022, https://www.nejm.org/doi/full/10.1056/NEJMoa2206038. 

Ferruggia, Kennedy. “GLP-1 Medications Can Increase Testosterone Levels in Men  
With Obesity.” Pharmacy Times, 21 July 2025, https://www.pharmacytimes.com/view/glp-1-medications-can-increase-testosterone-levels-in-men-with-obesity 

Kristensen, Søren L., et al. “Cardiovascular, Mortality, and Kidney Outcomes with GLP-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Cardiovascular Outcome Trials.” The Lancet Diabetes & Endocrinology, vol. 7, no. 10, Oct. 2019, pp. 776-785, https://doi.org/10.1016/S2213-8587(19)30249-9. 

Gregoric, Nadan, et al. “The Effects of Semaglutide vs Testosterone Replacement Therapy on Functional Hypogonadism and Sperm Quality in Men with Type 2 Diabetes Mellitus and Obesity.” Endocrine Abstracts, vol. 99, 2024, OC12.5, https://www.endocrine-abstracts.org/ea/0099/ea0099oc12.5. 

Wilding, John P. H., et al. “Once-Weekly Semaglutide in Adults with Overweight or Obesity.” New England Journal of Medicine, vol. 384, no. 11, 18 Mar. 2021, pp. 989-1002, https://pubmed.ncbi.nlm.nih.gov/33567185/. 

Duncan, Jessica, et al. “Individualized Virtual Integrative Medicine (IVIM): A Clinical Model for Enhanced GLP-1 Therapeutic Outcomes.” Obesity Pillars, vol. 15, 30 June 2025, 100188, https://pubmed.ncbi.nlm.nih.gov/40687923/. 

Piché, Marie-Eve, André Tchernof, and Jean-Pierre Després. “Obesity Phenotypes, Diabetes, and Cardiovascular Diseases.” Circulation Research, vol. 126, no. 11, 21 May 2020, https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.120.316101. 

Ferhatbegović, Lamija, Denis Mršić, and Amra Macić-Džanković. “The Benefits of GLP1 Receptors in Cardiovascular Diseases.” Frontiers in Clinical Diabetes and Healthcare, vol. 4, 8 Dec. 2023, 1293926, https://pmc.ncbi.nlm.nih.gov/articles/PMC10739421/. 

besity Medicine Association. “Obesity and Sleep Apnea: Understanding the Connection.” Obesity Medicine Association, 18 Nov. 2024, https://obesitymedicine.org/blog/sleep-apnea-and-obesity/. 

Cross, Paul Ian. “Study Identifies 3 Strategies to Minimize Muscle Loss from GLP-1 Weight Loss Drugs.” Medical News Today, 14 Apr. 2025, https://www.medicalnewstoday.com/articles/study-3-strategies-minimize-muscle-loss-glp-1-weight-loss-drugs. 

Mouser, J. Grant, et al. “The Association between Physiologic Testosterone Levels, Lean Mass, and Fat Mass in a Nationally Representative Sample of Men in the United States.” Steroids, vol. 115, Nov. 2016, pp. 62-66, https://www.sciencedirect.com/science/article/abs/pii/S0039128X16301052. 

Brodsky, I. G., et al. “Effects of Testosterone Replacement on Muscle Mass and Muscle Protein Synthesis in Hypogonadal Men–a Clinical Research Center Study.” Journal of Clinical Endocrinology and Metabolism, vol. 81, no. 10, Oct. 1996, pp. 3469-75, https://pubmed.ncbi.nlm.nih.gov/8855787/. 

Mozaffarian, Dariush, et al. “Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory From the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society.” American Journal of Lifestyle Medicine, 30 May 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC12125019/. 

Locatelli, João Carlos, et al. “Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition?” Diabetes Care, vol. 47, no. 10, 30 Apr. 2024, pp. 1718-1730, https://diabetesjournals.org/care/article/47/10/1718/154535/Incretin-Based-Weight-Loss-Pharmacotherapy-Can. 

Li, Guangqi, et al. “Amino Acids Regulating Skeletal Muscle Metabolism: Mechanisms of Action, Physical Training Dosage Recommendations and Adverse Effects.” Nutrition & Metabolism, vol. 21, no. 1, 2 July 2024, article 41, https://pubmed.ncbi.nlm.nih.gov/38956658/. 

“How Does Testosterone Affect Sleep?” Sleep Foundation, 16 July 2025, https://www.sleepfoundation.org/physical-health/sleep-and-testosterone. 

Dattilo, M., et al. “Sleep and Muscle Recovery: Endocrinological and Molecular Basis for a New and Promising Hypothesis.” Medical Hypotheses, vol. 77, no. 2, Aug. 2011, pp. 220-22, https://pubmed.ncbi.nlm.nih.gov/21550729/. 

Okobi, Okelue E., et al. “Impact of Weight Loss on Testosterone Levels: A Review of BMI and Testosterone.” Cureus, vol. 16, no. 12, 21 Dec. 2024, e76139, https://pubmed.ncbi.nlm.nih.gov/39840189/. 

Gregoric, Nadan, et al. “The Effects of Semaglutide vs Testosterone Replacement Therapy on Functional Hypogonadism and Sperm Quality in Men with Type 2 Diabetes Mellitus and Obesity.” Endocrine Abstracts, vol. 99, 2024, OC12.5, https://www.endocrine-abstracts.org/ea/0099/ea0099oc12.5. 

Pelusi, Carla, and Renato Pasquali. “The Significance of Low Testosterone Levels in Obese Men.” Current Obesity Reports, vol. 1, 19 Aug. 2012, pp. 181-190, https://link.springer.com/article/10.1007/s13679-012-0029-4. 

Katib, Atif. “Mechanisms Linking Obesity to Male Infertility.” Central European Journal of Urology, vol. 68, no. 1, 13 Mar. 2015, pp. 79-85, https://pmc.ncbi.nlm.nih.gov/articles/PMC4408383/. 

Service, Chad Austin, et al. “The Impact of Obesity and Metabolic Health on Male Fertility: A Systematic Review.” Fertility and Sterility, vol. 120, no. 6, Dec. 2023, pp. 1098-1111, https://www.sciencedirect.com/science/article/pii/S0015028223019350. 

Moon, Ki Hak, et al. “Obesity and Erectile Dysfunction: From Bench to Clinical Implication.” World Journal of Men’s Health, vol. 37, no. 2, 25 July 2018, pp. 138-147, https://pmc.ncbi.nlm.nih.gov/articles/PMC6479091/. 

Stárka, Luboslav, et al. “Estradiol, Obesity and Hypogonadism.” Physiological Research, vol. 69, suppl. 2, 1 Sept. 2020, pp. S273-S278, https://pmc.ncbi.nlm.nih.gov/articles/PMC8603736/. 

Varnum, Alexandra Aponte, et al. “Impact of GLP-1 Agonists on Male Reproductive Health—A Narrative Review.” Medicina, vol. 60, no. 1, 27 Dec. 2023, article 50, https://pmc.ncbi.nlm.nih.gov/articles/PMC10820247/. 

Kohn, Taylor P., and Larry I. Lipshultz. “Comment on: Male Sexual Dysfunction Associated with GLP-1 Receptor Agonists: A Cross-Sectional Analysis of FAERS Data.” International Journal of Impotence Research, vol. 37, 15 July 2025, pp. 686-687, https://www.nature.com/articles/s41443-025-01121-7. 

Li, Hao, et al. “Effect of Weight Loss on Erectile Function in Men with Overweight or Obesity: A Meta-Analysis of Randomised Controlled Trials.” Andrologia, vol. 54, no. 1, Feb. 2022, e14250, https://pubmed.ncbi.nlm.nih.gov/34644814/. 

Maiorino, Maria Ida, et al. “Lifestyle Modifications and Erectile Dysfunction: What Can Be Expected?” Asian Journal of Andrology, vol. 17, no. 1, 9 Sept. 2014, pp. 5-10, https://pmc.ncbi.nlm.nih.gov/articles/PMC4291878/. 

View all posts