What the Ozempic® documents contain
We searched the US label, EU product information and Canadian monograph for erectile, libido and sexual function. The only matches are animal findings: young rats given semaglutide reached sexual maturity later, with no impact on later fertility. [2][3] The table below lists the label content that touches sexual health indirectly.
| Topic | What the document says | Source |
|---|---|---|
| Erectile dysfunction, low libido, orgasm problems | Not listed | US, EU and Canada [1][2][3] |
| Tiredness (fatigue and weakness) | 2.6% on 0.5 mg and 3.3% on 1 mg vs 1.4% on comparators | Canada, Table 2 [3] |
| Low blood sugar with a sulfonylurea | Documented symptomatic episodes in 17.3% (0.5 mg) and 24.4% (1 mg) | US section 6.1 [1] |
| Pill hormones | No clinically relevant change in ethinyl estradiol or levonorgestrel exposure | US section 12.3; EU section 4.5 [1][2] |
| Contraception | Recommended for women who could become pregnant | EU section 4.6; Canada 7.1.1 [2][3] |
| Planning a pregnancy | Stop at least 2 months before | US section 8.3 [1] |
Diabetes and sex: the background
NIDDK explains that high blood glucose damages blood vessels and nerves, including those of the genitals and urinary tract. Men with diabetes are more than three times as likely to develop erectile dysfunction as men without it, more than half eventually do, and it tends to start 10 to 15 years earlier. Low testosterone is more common in men with diabetes, especially if they are older or overweight. [4]
For women, NIDDK lists low desire and arousal, too little lubrication, reduced feeling in the genitals, difficulty reaching orgasm and painful sex, driven by nerve damage, reduced blood flow and hormonal changes. Women with diabetes are also more prone to yeast and bladder infections, which can make sex uncomfortable. [4] A 2025 review describes erectile dysfunction as a common but under-recognised microvascular complication of diabetes, affecting up to three in four people with the condition. [5]
In other words, many people starting Ozempic® already have sexual problems or the risk factors for them. That makes timing worth noting: did the change start before, or after, the first injections?
What studies of semaglutide in diabetes show
- Adverse event reports: a 2026 analysis of FDA reports found 49 erectile dysfunction reports with semaglutide and a modest disproportionality signal (reporting odds ratio 1.53), almost identical to those for sitagliptin and dapagliflozin, two diabetes medicines from other classes. Dulaglutide and metformin showed no signal. Reports were spread across treatment time rather than clustered after starting. [6] The authors stress that this cannot establish cause.
- Health records: in men aged 18 to 70 with type 2 diabetes and no prior erectile dysfunction, tirzepatide was linked to fewer new diagnoses or erection-pill prescriptions than injectable semaglutide, dulaglutide or sitagliptin. [7] This compares medicines with each other, not semaglutide with no treatment, and randomised trials are needed.
- Reviews: a 2025 narrative review notes that GLP-1 medicines were long expected to help erectile function through better glucose control, weight loss and vascular effects, while preliminary reports have raised concerns; it calls the evidence inconsistent. [5]
Why sex might change after starting Ozempic®
- Label-supported: tiredness is more common than on comparators, [3] and stomach effects cluster in the dose-escalation weeks. [1]
- Label-supported: low blood sugar is common when Ozempic® is combined with insulin or a sulfonylurea, [1] and NIDDK says both high and low glucose can affect arousal. [4]
- Proposed: better glucose control and weight loss could, over time, help nerve- and vessel-related problems, which is how NIDDK describes good diabetes management helping erectile dysfunction. [4] No Ozempic® trial measured sexual outcomes.
- General: Cleveland Clinic lists being over 40, a BMI over 25, depression, inactivity, smoking, high blood pressure and some blood pressure medicines among risk factors for erectile dysfunction. [8] Stress, relationships and body image matter for all sexes. [9]
Planning around low blood sugar
If you use insulin or a sulfonylurea, the Ozempic® label explains that the risk of low blood sugar rises and that those doses may need lowering when Ozempic® starts. [1] Sex is physical activity, and NIDDK suggests checking glucose before and after, especially with insulin. [4] Signs listed in the Ozempic® Medication Guide include shakiness, sweating, a fast heartbeat, confusion and dizziness. [1]
This is also a reason not to assume that every change during sex is a sexual side effect: feeling shaky, weak or light-headed can be a glucose problem first. [1][4]
Getting help
NIDDK encourages people with diabetes to raise sexual problems with their care team, describing them as possible signs that diabetes management needs adjusting, and notes that counselling and including a partner can help. [4] For women, MedlinePlus suggests seeing a provider when problems last more than a few months or cause distress. [9] Cleveland Clinic recommends a primary care physician or urologist for erectile dysfunction. [8]
If you are planning a pregnancy, the Ozempic® label asks you to stop at least 2 months beforehand, [1] and NIDDK stresses getting blood glucose close to target before conceiving. [4]
Ozempic® is a registered trademark of Novo Nordisk A/S. Mounjaro® is a registered trademark of Eli Lilly and Company. PepLabo is not affiliated with or endorsed by Novo Nordisk or Eli Lilly and Company.
When to get help
The signs and contact information below come from this article’s sourced guidance.
Emergency
- A painful erection lasting longer than two to four hours after taking an erection medicine
Contact: Emergency room
Cleveland Clinic [8]
- Shakiness, sweating, confusion or a fast heartbeat during or after sex, with insulin or a sulfonylurea
Contact: Treat low blood sugar as shown, then tell your prescriber