# Do GLP-1 Drugs Raise Testosterone? Not in the Trials That Measured It | This GLP Do GLP-1 drugs raise testosterone? A 23-trial network in 1,899 men, a 25-man randomized head-to-head, and a matched cohort on erectile function. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/do-glp1-drugs-raise-testosterone Updated: 2026-09-17 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # Do GLP-1 Drugs Raise Testosterone? Not in the Trials That Measured It Five strategies for obesity-related low testosterone across 23 trials, and the significant increases belong to the other four. Weight loss still helps the condition. [This GLP Editorial Team](https://thisglp.com/about)September 20269 min readUpdated September 2026 What each strategy actually moved · TRT + structured lifestyle · testosterone ↑, erectile function ↑, lean mass ↑ · endogenous restoration · testosterone ↑, lean mass ↑ · testosterone replacement · testosterone ↑, waist ↓, lean mass ↑, hematocrit ↑ · every intervention · HbA1c — no significant change · 23 trials, 1,899 men — and no single winner **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). Weight loss does raise testosterone, and the trial evidence still does not put a GLP-1 among the strategies shown to do it. A network meta-analysis of 23 randomized trials in 1,899 men with obesity-related low testosterone tested five strategies, and GLP-1-based therapy was one of them [\[1\]](https://thisglp.com/research/do-glp1-drugs-raise-testosterone#ref-1). The increases it reports as significant belong to testosterone replacement with lifestyle therapy at MD 7.19, endogenous restoration at 4.14 and replacement alone at 2.53. The only randomized head-to-head enrolled 25 men for 24 weeks, and total testosterone rose in both arms [\[2\]](https://thisglp.com/research/do-glp1-drugs-raise-testosterone#ref-2). Nobody selling these drugs online measures the hormone, which is the gap running through [the sexual-function evidence](https://thisglp.com/research/do-glp1-drugs-affect-sex-drive) as well. ## Key takeaways - A network meta-analysis pooled 23 randomized trials covering 1,899 men with obesity-related low testosterone. - Testosterone replacement plus structured lifestyle therapy raised total testosterone most, MD 7.19, 95% CI 1.18 to 13.21. - It was also the only strategy that significantly improved erectile function scores, MD 1.29, 95% CI 0.07 to 2.50. - GLP-1-based therapy was one of the five interventions and does not appear among the significant results the abstract reports. - In the one randomized comparison, 25 men took semaglutide or testosterone for 24 weeks and testosterone rose in both arms. - A matched cohort found tirzepatide associated with fewer erectile dysfunction diagnoses, risk ratio 0.67 against injectable semaglutide. - No intervention significantly reduced glycated hemoglobin, and the authors decline to name a best treatment. ## What was compared Randomized trials of structured lifestyle therapy, testosterone replacement, endogenous testosterone restoration, GLP-1-based therapy, or testosterone replacement combined with structured lifestyle therapy, searched to April 2026. [\[1\]](https://thisglp.com/research/do-glp1-drugs-raise-testosterone#ref-1) Twenty-three trials and 1,899 participants went into a frequentist network, with risk of bias assessed by RoB 2 and confidence in each comparison graded by CINeMA. Against usual care or placebo, testosterone replacement plus lifestyle therapy produced the largest increase in total testosterone, MD 7.19, 95% CI 1.18 to 13.21. Endogenous restoration followed at 4.14, 95% CI 0.74 to 7.54, and testosterone replacement alone at 2.53, 95% CI 0.26 to 4.81. Where the GLP-1 arm is GLP-1-based therapy was one of the five interventions in this network. It does not appear among the results the abstract reports as significant, and the abstract gives no estimate for it either way. That is an absence from a reported list rather than a published null, and the two cannot be separated from the abstract alone. The distinction matters, because a strategy that was estimated and found wanting is not the same as one that was never summarized. ## The one randomized comparison, and why it flatters the drug Twenty-five men with type 2 diabetes, obesity and functional hypogonadism were randomized to semaglutide 1 mg weekly or intramuscular testosterone undecanoate for 24 weeks, open-label [\[2\]](https://thisglp.com/research/do-glp1-drugs-raise-testosterone#ref-2). Total testosterone rose in both arms, and both improved on the Aging Symptoms scale, while only the testosterone arm improved significantly on erectile function. The semaglutide arm beat a comparator that suppresses sperm production, which is a lower bar than the headline suggests, and the full reading of that trial sits in [the fertility evidence](https://thisglp.com/research/do-glp1-drugs-affect-fertility). ## The nearest thing to an outcome Testosterone is a blood test, and the symptom most men actually bring in is erectile function. A retrospective cohort in the TriNetX network compared men aged 18 to 70 with type 2 diabetes and no prior erectile dysfunction, in three propensity-matched pairings. Tirzepatide was associated with a lower risk of a diagnosis or a PDE-5 prescription [\[3\]](https://thisglp.com/research/do-glp1-drugs-raise-testosterone#ref-3). Against sitagliptin the risk ratio was 0.70 (95% CI 0.64 to 0.76), against injectable semaglutide 0.67 (0.62 to 0.72), and against dulaglutide 0.55 (0.51 to 0.59). Its authors say randomized trials are needed to confirm it, and nothing in it measures the hormone itself. ## The outcomes disagree with each other Testosterone replacement plus lifestyle therapy was the only strategy that significantly improved erectile function on the International Index of Erectile Function, MD 1.29, 95% CI 0.07 to 2.50 — an interval that barely clears zero. Testosterone replacement alone reduced waist circumference and increased lean mass. It also increased hematocrit, which is the classic reason testosterone requires monitoring. Endogenous restoration and the combination also increased lean mass. And no intervention at all significantly reduced glycated hemoglobin. So the question “which treatment is best” has no answer here, and not for the usual reason. It is not that the evidence is too thin to separate them — though confidence in many comparisons was graded low or very low. It is that they genuinely do different things, and which one is best depends entirely on which symptom brought somebody in. ## Why that is the useful finding Because a man with obesity and low testosterone is usually presented with one option by whoever he happens to consult. A urologist reaches for testosterone. A weight clinic reaches for a GLP-1. A primary care physician reaches for lifestyle advice. Each is defensible and none is complete. The authors say explicitly that their findings should inform individualized decisions rather than a definitive ranking, and that longer head-to-head trials are needed. That is the correct conclusion from an analysis where the winner changes with the outcome — and it is a different situation from [a comparison too small to find a difference](https://thisglp.com/research/does-a-glp1-affect-surgery-outcomes). ## What it means for someone buying online Nobody on this roster treats hypogonadism, and no seller here measures testosterone. What they sell is weight loss, and weight loss genuinely helps obesity-related low testosterone — that is why the condition is called functional and reversible. If low testosterone is the reason somebody is considering a weight-loss drug, that is a conversation for a clinician who will measure it before and after, and repeat it. What a seller asks about before shipping is [measurably little](https://thisglp.com/tools/questions-they-leave-open), and the same silence covers the menopause question set out in [the subgroup nobody reported](https://thisglp.com/research/do-glp1-drugs-work-in-menopause). ## Frequently asked Do GLP-1 drugs raise testosterone? Weight loss raises it, but the 23-trial network that compared five strategies does not list GLP-1-based therapy among the ones that significantly raised total testosterone. The significant increases were MD 7.19 for replacement plus lifestyle therapy, 4.14 for endogenous restoration and 2.53 for replacement alone. Which treatment is best for obesity-related low testosterone? The authors decline to name one, because each strategy improved a different set of outcomes. Testosterone replacement plus structured lifestyle therapy raised testosterone most and was the only one to improve erectile function significantly. Did GLP-1 therapy help? It was one of the five interventions compared, and it does not appear among the results the abstract reports as significant. The abstract gives no estimate for it, so this page cannot say whether it was found wanting or simply not summarized. Is testosterone replacement risky? It raised hematocrit in this analysis, which is the standard reason it requires monitoring. No significant differences in adverse events overall were detected across the strategies. Did any of it improve blood sugar? No. No intervention significantly reduced glycated hemoglobin compared with usual care or placebo. ## Sources 1. \[1\] Yang L, et al. (2026). Treatment strategies for functional hypogonadism in obese men: a systematic review and network meta-analysis The Journal of Sexual Medicine. [PMID 42704281](https://pubmed.ncbi.nlm.nih.gov/42704281/) 2. \[2\] Gregorič N, et al. (2025). Semaglutide improved sperm morphology in obese men with type 2 diabetes mellitus and functional hypogonadism Diabetes, Obesity and Metabolism. [PMID 39511836](https://pubmed.ncbi.nlm.nih.gov/39511836/) 3. \[3\] Cowart K, Murphy C, Carris N. (2025). Association of tirzepatide with erectile dysfunction in people with type 2 diabetes Journal of Diabetes and Its Complications. [PMID 40614622](https://pubmed.ncbi.nlm.nih.gov/40614622/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? 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