Published online Sep 20, 2026. doi: 10.5662/wjm.119385
Revised: February 2, 2026
Accepted: February 25, 2026
Published online: September 20, 2026
Processing time: 165 Days and 18.3 Hours
Glucagon-like peptide receptors-1 agonists (GLP-1 agonists) have revolutionized the treatment of obesity and diabetes due to their potent effects on weight and glycemic control, and cardiorenal protection. However, emerging reports and post-marketing surveillance have raised concerns regarding erectile dysfunction (ED) or impotence in a subset of male patients.
To assess the association between GLP-1 agonists, ED, total (TT) and free tes
We systematically searched PubMed, Google Scholar, and Web of Science in November and December 2026 for articles examining the association between GLP-1 agonists and ED, with no publication date restriction. However, only articles published in the English language were eligible. The terms used were GLP-1 agonists, ED, semaglutide, liraglutide, ozympic, tirzepatide, dulaglutide, and Impotence.
One hundred seventy-two articles were found; after removing duplicates, 63 remained, of which 12 full texts were screened, and 7 studies were included in the final meta-analysis. Seven studies involving 237 males were included. GLP-1 agonist therapy improved ED score with a significant statistical difference, MD = 2.73, 95% confidence interval (CI): 1.64-3.83. A significant increase was found regarding TT, SHBG, and FSH, MD 73.04, 95%CI: 16.91-129.17, MD 7.00, 95%CI: 1.71-12.30, and MD 0.46, 95%CI: 0.01-0.91 respectively.
No significant differences were evident regarding the FT, and LH. GLP-1 agonists significantly improved ED, TT, SHBG, and FSH in males, no effects were observed on FT, and LH; larger ran
Core Tip: Glucagon-like peptide receptors-1 agonists (GLP-1 agonists) have revolutionized the treatment of obesity and diabetes due to their potent effects on weight and glycemic control, and cardiorenal protection. However, emerging reports and post-marketing surveillance have raised concerns regarding erectile dysfunction (ED) or impotence in a subset of male patients. Impotence is common and is associated with diabetes, obesity, and cardiovascular risk factors. Drugs that mitigate both impotence and cardiovascular risk are attractive. This review gave an insight about the effects of GLP-1 agonists and ED.
- Citation: Mirghani HO, AlQurashi AM. Glucagon-like receptor-1 agonists and impotence: A meta-analysis. World J Methodol 2026; 16(3): 119385
- URL: https://www.wjgnet.com/2222-0682/full/v16/i3/119385.htm
- DOI: https://dx.doi.org/10.5662/wjm.119385
Unsatisfactory sexual intercourse due to failure to achieve/maintain penile erection [erectile dysfunction (ED)] is common; the prevalence varies significantly with age and cardiovascular risk factors, including diabetes and high blood pressure[1]. One in five men over 40 years suffers from impotence, and the prevalence in men with diabetes mellitus (DM) is 52.5%[2]. Previous literature indicated that numerous factors-including obesity, type 2 diabetes, elevated basal metabolic rate, smoking, and alcohol use are major risk factors for impotence. In addition, sleep disturbances, depression, hypertension, atherosclerotic cardiovascular disease, as well as circulating sex hormone binding globulins (SHBG) and adiponectin levels contribute causally to the risk and progression of ED[3]. Metabolic abnormalities, including metabolic syndrome and obesity, have been consistently identified as significant risk factors for ED. On the other hand, ED has increasingly been recognized as an early clinical indicator of underlying metabolic and cardiovascular pathology, often manifesting several years before the onset of major adverse metabolic or cardiovascular events. Consequently, drugs that mitigate both ED and cardiovascular disease, like glucagon-like peptide receptors-1 agonists (GLP-1 agonists), are attractive[4].
Obesity is emerging as a rapidly growing healthcare problem globally, with psychological and reproductive burdens. The effects of obesity on reproductive function are mediated by structural, hormonal, and functional abnormalities[5]. There is an increasing trend of obesity and type 2 diabetes globally, resulting from urbanization, unhealthy diets, and lack of physical activity[6,7]. The prevalence of obesity worldwide increased significantly from 3.2% in 1975 to 10.8% in 2014 in men and from 6.4% to 14.9% in females. The prevalence is expected to reach 18% and 21% in men and women by the year 2025 worldwide[8]. Importantly, the prevalence of diabetes is 10.5% globally[9]. High body mass index (BMI) is impairing insulin sensitivity in the liver and decreases glucose uptake by the muscle, leading to insulin resistance, initiating a vicious circle.
Due to the increasing rates of type 2 diabetes and obesity, new treatments for both conditions have emerged. Glucagon-like receptors- agonists were approved for type 2 diabetes in 2005, and three are available for obesity (liraglutide, semaglutide, and tirzepatide)[8,10].
ED is associated with depression, low self-esteem, and overall psychological well-being[11]. In addition, ED is common in patients with coronary artery disease, including diabetes, high blood pressure, and dyslipidemia[12]. Importantly, a history of ED is regarded as a risk factor for acute myocardial infarction[13]. Furthermore, ED significantly impacts the patient's quality of life[14].
Both type 2 diabetes and high BMI could increase the risk of ED, due to the increasing uptake of GLP-1 agonists in treating both conditions[15]. We conducted this review, in which we aimed to assess the effects of GLP-1 agonists on ED This review assessed the association between GLP-1 agonists, ED, total (TT) and free testosterone (FT), SHBG, luteinizing hormone (LH), and follicular stimulating hormone (FSH).
This meta-analysis was conducted to address the association between GLP-1 agonists and male ED. The literature search was conducted during November and December 2025.
All clinical trials, prospective, retrospective, and case-control studies were included. The study must assess the effects of GLP-1 agonists on ED.
Case reports, cross-sectional studies, opinions, editorials, and systematic reviews were not included. In addition, studies that don't assess the effects of GLP-1 agonists on ED.
Primary outcomes: The primary outcomes were the effects of GLP-1 agonists on ED.
Secondary outcomes: The secondary outcomes were the effects of GLP-1 agonists on, ED, TT, FT, SHBG, LH, and FSH.
Two authors systematically searched the Literature during November and December 2026. PubMed, Google Scholar, and Web of Science were searched for articles examining the association between GLP-1 agonists and ED with no limitation to publication date. However, only articles published in the English language were eligible. The terms used were GLP-1 agonists, ED, semaglutide, liraglutide, ozympic, tirzepatide, dulaglutide, and Impotence. One hundred seventy-two articles were found, 63 articles remained after the removal of duplication, of which 12 full texts were screened, and 7 studies were included in the final meta-analysis (Figure 1).
A structured checklist was used to gather the author's name, country, year of publication, type of study, study duration, age of the participants, BMI, impotence level in patients on GLP-1 agonists and control subjects before and after GLP-1 agonists, and the total number of patients and control subjects. The levels of TT, FT, SHBG, LH, and FSH were measured before and after GLP-1 agonists (Table 1).
| Ref. | Country | Age/years/ | BMI/GLP-1 agonists/control | Study type | Duration | GLP-1 type | Control | Score before | Score after | Number of patients/GLP-1 agonists/control |
| Defeudis et al[19] | Italy | 64.1 ± 9.9 vs 62.3 ± 7.6 | 28.1 ± 3.6 vs 29.3 ± 5.6 | Prospetive | 48 months | GLP-1 agonists | Metformin | 15.5 ± 5.7 vs 16.7 ± 4.7 | - | 20 vs 51 |
| Giagull et al[20] | Italy | 53.5 ± 4.4 | 34.2 ± 2.4 | Retro. | 12 months | Liraglutide | Cross-over | 12 ± 2.2 vs 14.6 ± 1.7 | 14.6 ± 1.7 vs 19.9 ± 2 | 30 vs 16 |
| Giagulli et al[21] | Italy | 51.1 ± 2.9 | 33.5 ± 1.4 | Retro. | 12 months | Dulaglutide | Metformin | 15.7 ± 1.7 vs 15.1 ± 1.1 | 18.0 ± 1.0 vs 19.1 ± 1.2 | 14 vs 14 |
| Giagulli et al[21] | Italy | 49.8 ± 2.9 | 34.0 ± 1.5 | Retro | 12 months | Liraglutide | Metformin | 15.7 ± 1.7 vs 15.1 ± 1.1 | 15.1 ± 1.1 vs 18.7 ± 0.9 | 16 vs 16 |
| La Vignera et al[22] | Italy | 56.3 ± 4.7 vs 55.1 ± 5.2 | 35.3 ± 3.0 vs 34.6 ± 3.4 | Pilot | 8 weeks | Tirzepatide | Pilot | 6.6 ± 1.5 vs 7.1 ± 1.25 | 8.8 ± 1.5 vs 7.3 ± 1.25 | 28 vs 30 |
| Lengsfeld et al[23] | Switzerland | 23.5 ± 4.15 vs 25 ± 3.25 | 24.1 ± 1.35 vs 23.2 ± 1.15 | Trial | 4 weeks | Dulaglutide | Placebo | 9.8 ± 1 vs 10.4 ± 0.7 | 10.8 ± 2.6 vs 11 ± 1.9 | 12 vs 12 |
| Lisco et al[24] | Italy | 59 ± 4.5 vs 60 ± 3 | 34 ± 1.7 vs 33.7 ± 1.7 | Retro. | 12 months | Not specified | Metformin | 15.3 ± 1.4 vs 15.7 ± 1.7 | 18.9 ± 1.2 vs 16.7 ± 1.5 | 63 vs 45 |
The International Index of Erectile Function was used to assess the ED[16]. One study used the Massachusetts General Hospital Sexual Functioning Questionnaire[17].
The RevMan version 5.4, Oxford, United Kingdom, was used to analyze the continuous data from the studies to assess the effects of GLP-1 agonists on ED, TT, FT, SHBG, LH, and FSH. The data were entered manually, and the mean difference 95% confidence interval (CI) was used for forest plots, and funnel plots were generated for heterogeneity. I2 was used to assess the heterogeneity among studies (I2 > 50% was considered high). The random effect was used due to the significant heterogeneity. The χ2 test and the weighted average effect size (Z) were calculated. A sub-analysis was used by excluding studies contributing most to heterogeneity (by assessing heterogeneity impact, and removing outliers with extreme effect size, then we checked if heterogeneity (I²) decreases and whether the pooled effect size changes. A P value of < 0.05 was considered significant.
Risk of bias assessment and quality of evidence: The Newcastle Ottawa Scale risk of bias assessment was used[18]. The GRADE Evidence was used to assess the grade of evidence (Tables 2, 3 and 4).
| Ref. | TT before GLP-1 agonists | TT, after GLP-1 agonists | FT, before GLP-1 agonists | FT, after GLP-1 agonists | SHBG, before GLP-1 agonists | SHBG, after GLP-1 agonists | LH, before GLP-1 agonists | LH, after GLP-1 agonists | FSH, before GLP-1 agonists | FSH, GLP-1 agonists |
| Giagull et al[20] | 430.8 ± 51.8 | 450.8 ± 42.4 | 7.95 ± 1.2 | 8.3 ± 0.95 | 37.7 ± 2.4 | 39.0 ± 1.6 | Not assessed | Not assessed | Not assessed | Not assessed |
| Giagulli et al[21] | 259 ± 12 | 310 ± 37 | 4.9 ± 0.3 | 5.6 ± 0.7 | 34.5 ± 2.20 | 39.4 ± 1.7 | 6.6 ± 0.8 | 6.8 ± 0.4 | 6.5 ± 0.8 | 6.8 ± 0.5 |
| Giagulli et al[21] | 262 ± 11 | 328 ± 33 | 5 ± 0.3 | 6 ± 0.6 | 34.6 ± 2.3 | 39 ± 1.8 | 6.2. ± 0.7 | 6.8 ± 2.8 | 6.6 ± 0.7 | 6.9 ± 0.5 |
| La Vignera et al[22] | 140 ± 60 | 410 ± 50 | 5.1 ± 0.64 | Not assessed | 14 ± 3 | 36 ± 4 | 2.3 ± 0.3 | 3.2 ± 0.2 | 1.6 ± 0.3 | 2.6 ± 0.2 |
| Lengsfeld et al[23] | 19.7 ± 2.9 | 20.4. ± 3.2 | 0.4 ± 0.1 | 0.4 ± 0.1 | 36.5 ± 9.69 | 40.6. ± 4.68 | 5.2 ± 1.48 | 4.5 ± 1 | 3.1 ± 1.83 | 3.1 ± 1.68 |
| Lisco et al[24] | 303.7 ± 41.7 | 337.7 ± 34.7 | 5.9 ± 1.3 | 6.6 ± 0.42 | 35.4 ± 2.1 | 39.4 ± 1.7 | 6.3 ± 0.8 | 6.8 ± 0.8 | 6.6 ± 0.7 | 6.9 ± 0.7 |
| Outcome | Studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | GRADE |
| ED | 7 | Trial = 1, retrospective = 4, pilot study = 1 | Serious | Serious (I2 = 90%) | Not serious | Not serious | None | Very low |
| TT | 6 | Trial = 1, retrospective = 3, pilot study = 1 | Serious | Serious (I2 = 99%) | Not serious | Not serious | None | Very low |
| FT | 5 | Trial = 1, retrospective = 3, pilot study = 1 | Serious | Serious (I2 = 86%) | Not serious | Not serious | None | Very low |
| SHBG | 6 | Trial = 1, retrospective = 4, pilot study = 1 | Serious | Serious (I2 = 99%) | Not serious | Not serious | None | Very low |
| LH | 5 | Trial = 1, retrospective = 3, pilot study = 1 | Serious | Serious (I2 = 91%) | Not serious | Not serious | None | Very low |
| FSH | 5 | Trial = 1, retrospective = 3, pilot study = 1 | Serious | Serious (I2 = 91%) | Not serious | Not serious | None | Very low |
In this meta-analysis, we included seven studies[19-24] comprising 183 males treated with GLP-1 receptor agonists and 184 controls. Overall, GLP-1 agonist therapy improved ED score with a significant statistical difference, MD = 2.73, 95%CI: 1.64-3.83; P < 0.00001). However, substantial heterogeneity was observed across studies (τ² = 1.79; χ² = 59.49, P < 0.00001; I² = 90%), indicating considerable variability in effect sizes among the included trials (Figure 2A).
In a subgroup analysis, three studies involving 111 participants in the GLP-1 agonists group and 126 in the control group remained. A significant beneficial effect of GLP-1 receptor agonists on impotence was found (MD = 1.88, 95%CI: 1.33-2.43; P < 0.00001). Importantly, heterogeneity was markedly reduced and no longer statistically significant (τ² = 0.07; χ² = 2.70, P = 0.26; I² = 26%), suggesting that the observed treatment effect was robust and more consistent after removal of heterogeneity-driving studies. Overall, these findings indicate that GLP-1 receptor agonists are associated with significant improvements in impotence, with sensitivity analyses confirming the stability of the effect when methodological heterogeneity is minimized (Figure 2B).
Five studies assessed the total testosterone, the overall pooled mean difference demonstrates a significant increase in total testosterone in the GLP-1 agonist group compared with controls (MD 73.04, 95%CI: 16.91-129.17; Z = 2.55, P = 0.01). Substantial between-study heterogeneity was observed (τ² = 4816.83; χ² = 4021.13, P < 0.00001; I² = 99%), indicating marked variability in effect sizes across studies (Figure 2C).
Regarding the FT, no statistically significant difference was found between the GLP-1 agonist and control groups (MD 0.07, 95%CI: 0.01-0.14; Z = 1.73, P = 0.08). Moderate to substantial heterogeneity was observed (χ² = 27.93, df = 4, P < 0.0001; I² = 86%). Overall, these findings suggest that GLP-1 agonist therapy does not significantly alter FT levels compared with controls (Figure 2D).
The pooled analysis indicates a statistically significant increase in SHBG associated with GLP-1 agonist therapy compared with controls (MD 7.00, 95%CI: 1.71-12.30; Z = 2.59, P = 0.01). Considerable heterogeneity was observed among studies (τ² = 419.3; χ² = 421.80, P < 0.00001; I² = 99%), suggesting substantial between-study variability. Overall, GLP-1 agonist use appears to be associated with increased SHBG levels, although the high heterogeneity warrants cautious interpretation (Figure 2E).
Regarding the LH, no statistically significant difference was found between the GLP-1 agonist and control groups (MD 0.45, 95%CI: -0.14 to 1.04; Z = 1.48, P = 0.14). Moderate to substantial heterogeneity was observed (χ² = 45.26, df = 4, P < 0.0001; I² = 91%). Overall, these findings suggest that GLP-1 agonist therapy does not significantly alter LH levels compared with controls (Figure 2F).
The pooled analysis indicates a statistically significant increase in FSH associated with GLP-1 agonist therapy compared with controls (MD 0.46, 95%CI: 0.01-0.91; Z = 1.98, P = 0.05). Considerable heterogeneity was observed among studies (χ² = 42.43, df = 4, P < 0.0001; I² = 91%), suggesting substantial between-study variability (Figure 2G).
In this meta-analysis, the ED scores improved significantly by GLP-1 agonist therapy; the results remained significant after removing studies with high contribution to heterogeneity, MD = 2.73, 95%CI: 1.64-3.83, and MD = 1.88, 95%CI: 1.33-2.43, respectively. The current findings supported a previous review[25], which found improvement of ED scores with GLP-1 agonists. However, the authors included only three studies comparing GLP-1 agonists with metformin, and they found substantial heterogeneity, which limited their results. Another meta-analysis[26] found that GLP-1 agonists reduced ED score. However, their findings were limited by the high heterogeneity. DM is usually associated with other cardiovascular risk factors, including high blood pressure and dyslipidemia. In addition, DM leads to macrovascular and microvascular complications, leading to vascular damage and impotence[27,28]. In addition, DM is associated with oxidative stress, pro-inflammation, and chronic low-grade inflammation that significantly affects the blood vessels and nerves, leading to impotence[29]. GLP-1 agonists also reduce oxidative stress and vascular inflammation, improving cavernosal smooth muscle relaxation and penile arterial inflow. These effects directly translate into improved erectile rigidity and maintenance. In addition, GLP-1 agonists could improve ED through improving cardiovascular risk factors because of the shared pathophysiology[30,31].
Previous studies suggested that GLP-1 agonists could raise the bioavailable testosterone with no effects on SHBG, suggesting a possible endocrine benefit of GLP-1 therapy[32]. Improving the total and FT, and hypothalamic and pituitary hormones[33]. In this meta-analysis we found a significant increase in TT, SHBG, and FSH, MD 73.04, 95%CI: 16.91-129.17, MD 7.00, 95%CI: 1.71-12.30, and MD 0.46, 95%CI: 0.01-0.91 respectively. No significant differences were evident regarding the FT, and LH. Our findings were similar to Salvio et al[26] regarding TT, SHBG, and FSH. However, we found no effects on LH, and FT.
Evidence consistently shows that obesity is associated with a functional suppression of the hypothalamic-pituitary-gonadal axis, characterized by TT, FT, reduced SHBG, and inappropriately normal or low LH and FSH, a condition often termed obesity-related hypogonadism[34]. Emerging data on GLP-1 receptor agonists suggest that their beneficial effects on body weight, insulin resistance, and systemic inflammation are accompanied by increases in testosterone and SHBG and restoration of gonadotropin signaling, supporting the concept that metabolic improvement rather than a direct gonadal effect underlies hormonal recovery[35,36]. Additionally, GLP-1 agonists could enhance ED through weight loss, improving glycemic control, and improving hormonal profile[20].
The strength of this meta-analysis is that it included the largest up-to-date studies compared to the previous meta-analysis. In addition, we conducted a sensitivity analysis and showed an improvement in ED. However, the high heterogeneity due to the inclusion of studies with different methodologies significantly limited this study.
GLP-1 agonists are associated with significant improvement in ED and should be considered in patients with ED and cardiovascular risk factors. The effects on testicular-pituitary axis is not uniform with increments in TT, SHBG, and FSH. No significant differences were evident regarding the FT and LH. However, the evidence is weak; further randomized controlled trials assessing different doses and types of GLP-1 agonists are needed.
We would like to acknowledge Dr. Ihab Farah, a Biostatistician, University of Tabuk, Saudi Arabia, and Mohannad Osman, Medical student, Prince Fahd Bin Sultan University, Tabuk, Saudi Arabia, for the statistics revision, and recording the core tip, respectively.
| 1. | Jin M, Yuan S, Wang B, Yi L, Wang C. Association Between Prediabetes and Erectile Dysfunction: A Meta-Analysis. Front Endocrinol (Lausanne). 2021;12:733434. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in RCA: 16] [Reference Citation Analysis (0)] |
| 2. | Kouidrat Y, Pizzol D, Cosco T, Thompson T, Carnaghi M, Bertoldo A, Solmi M, Stubbs B, Veronese N. High prevalence of erectile dysfunction in diabetes: a systematic review and meta-analysis of 145 studies. Diabet Med. 2017;34:1185-1192. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 180] [Cited by in RCA: 304] [Article Influence: 33.8] [Reference Citation Analysis (0)] |
| 3. | Xiong Y, Zhang F, Zhang Y, Wang W, Ran Y, Wu C, Zhu S, Qin F, Yuan J. Insights into modifiable risk factors of erectile dysfunction, a wide-angled Mendelian Randomization study. J Adv Res. 2024;58:149-161. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 36] [Cited by in RCA: 61] [Article Influence: 30.5] [Reference Citation Analysis (0)] |
| 4. | Meng X, Rao K, Chen J. Editorial: Metabolic factors in erectile dysfunction. Front Endocrinol (Lausanne). 2023;14:1344191. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 6] [Reference Citation Analysis (0)] |
| 5. | Kalra S, Dhingra A, Kapoor N. Obesity Associated Reproductive and Sexual Syndrome(OARS) in Men. J Pak Med Assoc. 2024;74:2016-2017. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 1] [Reference Citation Analysis (0)] |
| 6. | Klein S, Gastaldelli A, Yki-Järvinen H, Scherer PE. Why does obesity cause diabetes? Cell Metab. 2022;34:11-20. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 777] [Cited by in RCA: 653] [Article Influence: 163.3] [Reference Citation Analysis (6)] |
| 7. | Chandrasekaran P, Weiskirchen R. The Role of Obesity in Type 2 Diabetes Mellitus-An Overview. Int J Mol Sci. 2024;25:1882. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 351] [Cited by in RCA: 276] [Article Influence: 138.0] [Reference Citation Analysis (1)] |
| 8. | Elmaleh-Sachs A, Schwartz JL, Bramante CT, Nicklas JM, Gudzune KA, Jay M. Obesity Management in Adults: A Review. JAMA. 2023;330:2000-2015. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 545] [Cited by in RCA: 489] [Article Influence: 163.0] [Reference Citation Analysis (5)] |
| 9. | Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JCN, Mbanya JC, Pavkov ME, Ramachandaran A, Wild SH, James S, Herman WH, Zhang P, Bommer C, Kuo S, Boyko EJ, Magliano DJ. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 8030] [Cited by in RCA: 6426] [Article Influence: 1606.5] [Reference Citation Analysis (15)] |
| 10. | Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Mol Metab. 2021;46:101102. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 1294] [Cited by in RCA: 1160] [Article Influence: 232.0] [Reference Citation Analysis (6)] |
| 11. | Wróblewski O, Skwirczyńska E, Michalczyk K, Zaeir S, Zair L, Kraszewska K, Kiryk J, Bobik A, Mikołajczyk-Kocięcka A, Chudecka-Głaz A. The Relationship between Erectile Dysfunction, Self-Esteem, and Depression in Post-Myocardial Infarction Patients. J Clin Med. 2024;13:6134. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 3] [Reference Citation Analysis (0)] |
| 12. | Rinkūnienė E, Gimžauskaitė S, Badarienė J, Dženkevičiūtė V, Kovaitė M, Čypienė A. The Prevalence of Erectile Dysfunction and Its Association with Cardiovascular Risk Factors in Patients after Myocardial Infarction. Medicina (Kaunas). 2021;57:1103. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 8] [Cited by in RCA: 18] [Article Influence: 3.6] [Reference Citation Analysis (0)] |
| 13. | Adam A, McDowall J, Aigbodion SJ, Enyuma C, Buchanan S, Vachiat A, Sheahan J, Laher AE. Is the History of Erectile Dysfunction a Reliable Risk Factor for New Onset Acute Myocardial Infarction? A Systematic Review and Meta-Analysis. Curr Urol. 2020;14:122-129. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 3] [Cited by in RCA: 7] [Article Influence: 1.2] [Reference Citation Analysis (0)] |
| 14. | Muller DRP, Stenvers DJ, Malekzadeh A, Holleman F, Painter RC, Siegelaar SE. Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence. Front Endocrinol (Lausanne). 2023;14:1215356. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 65] [Cited by in RCA: 113] [Article Influence: 37.7] [Reference Citation Analysis (1)] |
| 15. | Kijima FJ, Motta LC, Cavalcante JS, Jordão L, Olioze CED, Santos PTKP, Cruz JCLD, Sabage LE, Medeiros GA, Mazzo A, Nardi AC. Prevalence and quality of life associated with erectile dysfunction and lower urinary tract symptoms: a cross-sectional study. Sao Paulo Med J. 2024;143:e2024045. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in RCA: 2] [Reference Citation Analysis (0)] |
| 16. | Rosen RC, Cappelleri JC, Gendrano N 3rd. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14:226-244. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 699] [Cited by in RCA: 731] [Article Influence: 30.5] [Reference Citation Analysis (0)] |
| 17. | Hernández-Soberón JC, Torres-Obregón R, Carrillo Cervantes AL, Medina-Fernández IA, Sierra JC, Onofre-Rodríguez DJ. [Psychometric properties of the Massachusetts General Hospital-Sexual Functioning Questionnaire in elderly people]. Rev Int Androl. 2022;20:170-177. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 2] [Reference Citation Analysis (0)] |
| 18. | Carra MC, Romandini P, Romandini M. Risk of Bias Evaluation of Cross-Sectional Studies: Adaptation of the Newcastle-Ottawa Scale. J Periodontal Res. 2025;. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 94] [Reference Citation Analysis (0)] |
| 19. | Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, Faggiano A, Pozzilli P, Isidori AM, Gianfrilli D. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes Metab Res Rev. 2022;38:e3494. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 101] [Cited by in RCA: 190] [Article Influence: 47.5] [Reference Citation Analysis (2)] |
| 20. | Giagulli VA, Carbone MD, Ramunni MI, Licchelli B, De Pergola G, Sabbà C, Guastamacchia E, Triggiani V. Adding liraglutide to lifestyle changes, metformin and testosterone therapy boosts erectile function in diabetic obese men with overt hypogonadism. Andrology. 2015;3:1094-1103. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 44] [Cited by in RCA: 80] [Article Influence: 7.3] [Reference Citation Analysis (0)] |
| 21. | Giagulli VA, Castellana M, Carbone MD, Pelusi C, Ramunni MI, De Pergola G, Guastamacchia E, Triggiani V. Weight loss more than glycemic control may improve testosterone in obese type 2 diabetes mellitus men with hypogonadism. Andrology. 2020;8:654-662. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 15] [Cited by in RCA: 35] [Article Influence: 5.8] [Reference Citation Analysis (0)] |
| 22. | La Vignera S, Cannarella R, Garofalo V, Crafa A, Barbagallo F, Condorelli RA, Calogero AE. Short-term impact of tirzepatide on metabolic hypogonadism and body composition in patients with obesity: a controlled pilot study. Reprod Biol Endocrinol. 2025;23:92. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 6] [Cited by in RCA: 10] [Article Influence: 10.0] [Reference Citation Analysis (0)] |
| 23. | Lengsfeld S, Probst L, Emara Y, Werlen L, Vogt DR, Bathelt C, Baur F, Caviezel B, Vukajlovic T, Fischer M, Winzeler B. Effects of the glucagon-like peptide-1 receptor agonist dulaglutide on sexuality in healthy men: a randomised, double-blind, placebo-controlled crossover study. EBioMedicine. 2024;107:105284. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 16] [Reference Citation Analysis (0)] |
| 24. | Lisco G, Bartolomeo N, De Tullio A, De Pergola G, Guastamacchia E, Jirillo E, Piazzolla G, Triggiani V, Giagulli VA. Long-acting glucagon-like peptide 1 receptor agonists boost erectile function in men with type 2 diabetes mellitus complaining of erectile dysfunction: A retrospective cohort study. Andrology. 2024;12:633-642. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 18] [Cited by in RCA: 32] [Article Influence: 16.0] [Reference Citation Analysis (0)] |
| 25. | Yang B, Cheng H, Hu Y, Chen Y, Xu Y, Huang W, Long Y, Gao C. Effects of Anti-Diabetic Drugs on Erectile Dysfunction: A Systematic Review and Meta-Analysis. Diabetes Metab Syndr Obes. 2025;18:467-478. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in RCA: 14] [Reference Citation Analysis (0)] |
| 26. | Salvio G, Ciarloni A, Ambo N, Bordoni M, Perrone M, Rossi S, Balercia G. Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis. Andrology. 2025;13:2022-2034. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 7] [Cited by in RCA: 20] [Article Influence: 20.0] [Reference Citation Analysis (0)] |
| 27. | Zamponi V, Haxhi J, Pugliese G, Faggiano A, Mazzilli R. Diabetes technology and sexual health: which role? J Endocrinol Invest. 2024;47:1315-1321. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 3] [Reference Citation Analysis (0)] |
| 28. | Moon KH, Park SY, Kim YW. Obesity and Erectile Dysfunction: From Bench to Clinical Implication. World J Mens Health. 2019;37:138-147. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 19] [Cited by in RCA: 67] [Article Influence: 8.4] [Reference Citation Analysis (0)] |
| 29. | Weinberg Sibony R, Segev O, Dor S, Raz I. Overview of oxidative stress and inflammation in diabetes. J Diabetes. 2024;16:e70014. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 183] [Cited by in RCA: 157] [Article Influence: 78.5] [Reference Citation Analysis (1)] |
| 30. | Randrup E, Baum N, Feibus A. Erectile dysfunction and cardiovascular disease. Postgrad Med. 2015;127:166-172. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 11] [Cited by in RCA: 26] [Article Influence: 2.2] [Reference Citation Analysis (0)] |
| 31. | Antonič KG, Zitzmann M. The male hormone reset: how GLP-1RAs, lifestyle and testosterone transform obesity-linked problems. Aging Male. 2025;28:2601423. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 1] [Reference Citation Analysis (0)] |
| 32. | Orra SH, Martinez JVN, Porto BC, Passerotti CC, Sardenberg RAS, Da Cruz JAS. Effect of GLP-1 agonists on testosterone levels: a systematic review and meta-analysis. BMC Urol. 2025;25:311. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in RCA: 3] [Reference Citation Analysis (0)] |
| 33. | La Vignera S, Condorelli RA, Calogero AE, Cannarella R, Aversa A. Sexual and Reproductive Outcomes in Obese Fertile Men with Functional Hypogonadism after Treatment with Liraglutide: Preliminary Results. J Clin Med. 2023;12:672. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in RCA: 43] [Reference Citation Analysis (0)] |
| 34. | Wu FC, Tajar A, Pye SR, Silman AJ, Finn JD, O'Neill TW, Bartfai G, Casanueva F, Forti G, Giwercman A, Huhtaniemi IT, Kula K, Punab M, Boonen S, Vanderschueren D; European Male Aging Study Group. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab. 2008;93:2737-2745. [RCA] [PubMed] [DOI] [Full Text] [Cited by in Crossref: 612] [Cited by in RCA: 643] [Article Influence: 35.7] [Reference Citation Analysis (0)] |
| 35. | Yazıcı D, Yapıcı Eser H, Kıyıcı S, Sancak S, Sezer H, Uygur M, Yumuk V. Clinical Impact of Glucagon-Like Peptide-1 Receptor Analogs on the Complications of Obesity. Obes Facts. 2023;16:149-163. [RCA] [PubMed] [DOI] [Full Text] [Cited by in RCA: 17] [Reference Citation Analysis (0)] |
| 36. | Vilsbøll T, Christensen M, Junker AE, Knop FK, Gluud LL. Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials. BMJ. 2012;344:d7771. [RCA] [PubMed] [DOI] [Full Text] [Full Text (PDF)] [Cited by in Crossref: 780] [Cited by in RCA: 692] [Article Influence: 49.4] [Reference Citation Analysis (5)] |