Emerging data presented at ENDO 2025 on July 14 reveal that GLP‑1 receptor agonists—widely used for diabetes and obesity—may offer a new avenue to boost testosterone in men, marking a breakthrough in men’s metabolic and reproductive health.
A cohort study of 110 obese or type 2 diabetic men treated with semaglutide (Ozempic/Wegovy), dulaglutide (Trulicity), or tirzepatide (Zepbound) over 18 months demonstrated a remarkable increase in average testosterone levels—from roughly 53% of the norm to 77%—coinciding with an average weight loss of around 10%. This finding positions GLP‑1 drugs as a dual-benefit therapy, simultaneously addressing metabolic health and low testosterone.
Endocrinology fellow Dr. Shellsea Portillo Canales noted that GLP‑1 medications enhance insulin sensitivity, reduce inflammation, and decrease aromatase activity—the enzyme that converts testosterone to estrogen—which together help reverse functional hypogonadism without the need for hormone therapy. The impact of these drugs extends beyond blood sugar control and weight management, offering a physiological shift that naturally restores testosterone production by targeting underlying metabolic dysfunction.
Additional observational evidence from ENDO‑related data further supports these outcomes. In one study, liraglutide not only increased total testosterone but also lifted gonadotropin levels, while semaglutide preserved these reproductive hormones. Improvements in sperm count, motility, and morphology were also reported, which holds particular promise for men concerned with fertility. These results are especially relevant in contrast to traditional testosterone replacement therapy, which can often suppress the body’s natural sperm production and limit reproductive potential.
This development aligns with broader scientific findings that GLP‑1 agonists deliver extensive benefits across cardiovascular, renal, and metabolic domains. Now, their impact appears to extend to male reproductive health, opening new possibilities for treating low testosterone through non-hormonal means.
Clinicians increasingly recognize the potential of GLP‑1 drugs to reshape therapeutic strategies. These medications may become a preferred first-line option for men with metabolic dysfunction and borderline low testosterone, particularly for those who are overweight or have type 2 diabetes. The appeal lies in their dual capacity to manage chronic metabolic disease while improving testosterone levels without directly manipulating hormones.
However, healthcare providers caution that these treatments are not without risk. Known side effects include nausea, gastrointestinal discomfort, and, in rare cases, pancreatitis. Therefore, careful patient selection and close monitoring are essential. Cost and insurance coverage also remain hurdles for broader adoption, as these drugs can be expensive and are not always covered for off-label uses related to hormonal health.
Experts emphasize the need for more robust clinical trials to validate the early findings and determine the long-term impact of GLP‑1 therapy on testosterone levels and overall reproductive function. In the meantime, endocrinologists and urologists alike are cautiously optimistic, seeing this as an exciting development in men’s health that bridges metabolic control with hormone balance.
Dr. Portillo Canales highlighted that these drugs could be particularly useful for men seeking alternatives to testosterone therapy, especially those looking to preserve fertility while addressing symptoms of low testosterone. The implications are far-reaching, potentially transforming how clinicians approach male hypogonadism and metabolic syndrome.
As obesity, diabetes, and related metabolic disorders continue to affect millions of men nationwide, the potential to address two major health concerns with a single class of medications could signal a new era in preventive and restorative men’s health care.