Lidewij S Boogers, Elena S F McDonnell, Annelou L C de Vries, Martin den Heijer, A S Paul van Trotsenburg, Chantal M Wiepjes, Sabine E Hannema
{"title":"Response to Letter to the Editor on \"Feminine figures: body image and physical characteristics in trans women after puberty suppression and subsequent estradiol therapy\".","authors":"Lidewij S Boogers, Elena S F McDonnell, Annelou L C de Vries, Martin den Heijer, A S Paul van Trotsenburg, Chantal M Wiepjes, Sabine E Hannema","doi":"10.1093/jsxmed/qdaf405","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf405","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Ghassab Deameh, Mohamed Ramez, Rashed Rowaiee, Baha' Aldeen Bani Irshid, Hamza Mohamed, Abdelrahman Abdelshafi, Mohammad Ali Al-Osoufi, Tarek Mohamed, Safa Botros Hegazin, Omer Raheem
Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are antidiabetic agents that also induce weight loss. Their widespread use has prompted investigation of potential benefits beyond glycemic control, including effects on male sexual and reproductive function. Emerging evidence suggests that they may improve male reproductive parameters, particularly in men with metabolic dysfunction.
Objectives: To systematically evaluate the effects of GLP-1RAs (liraglutide, semaglutide, dulaglutide, and exenatide) on male reproductive hormones, semen parameters, and metabolic outcomes.
Methods: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched in PubMed, Embase, Scopus, and Web of Science up to April 2025. Eligible studies included randomized controlled trials (RCTs) and cohort studies evaluating the effects of GLP-1RAs in adult men. Assessed the risk of bias with the risk of bias 2 tool for RCT and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool for observational studies.
Results: Ten studies involving a total of 639 men were included. GLP-1RAs were consistently associated with increased total testosterone, particularly in men with obesity, type 2 diabetes, or functional hypogonadism. Free testosterone changes were inconsistent, often offset by concurrent rises in sex hormone-binding globulin. Luteinizing hormone and follicle-stimulating hormone levels were preserved or increased with GLP-1RA use, in contrast to the suppression observed in testosterone therapy comparator groups. Improvements in semen parameters were reported in obese or hypogonadal men; however, no significant changes were found in healthy individuals.
Conclusion: GLP-1RAs may improve testosterone levels and potentially enhance semen quality in men with metabolic issues, while maintaining gonadotropin function. They could serve as fertility-sparing alternatives to testosterone therapy in some obesity-related hypogonadism cases. More long-term, controlled studies with standardized fertility measures are needed to confirm their role in male reproductive health.
简介：胰高血糖素样肽-1受体激动剂（GLP-1RAs）是一种抗糖尿病药物，也可诱导体重减轻。它们的广泛使用促使了对血糖控制之外的潜在益处的研究，包括对男性性功能和生殖功能的影响。新出现的证据表明，它们可以改善男性生殖参数，特别是对有代谢功能障碍的男性。目的：系统评价GLP-1RAs（利拉鲁肽、西马鲁肽、杜拉鲁肽和艾塞那肽）对男性生殖激素、精液参数和代谢结果的影响。方法：我们按照系统评价和荟萃分析指南的首选报告项目进行了系统评价。我们在PubMed， Embase， Scopus和Web of Science中检索到2025年4月。符合条件的研究包括评估GLP-1RAs对成年男性影响的随机对照试验（rct）和队列研究。使用RCT的偏倚风险2工具和观察性研究的非随机干预研究的偏倚风险（ROBINS-I）工具评估偏倚风险。结果：10项研究共纳入639名男性。GLP-1RAs始终与总睾酮增加有关，特别是在肥胖、2型糖尿病或功能性性腺功能减退的男性中。游离睾酮的变化是不一致的，经常被性激素结合球蛋白的同时升高所抵消。使用GLP-1RA时，黄体生成素和卵泡刺激素水平保持或升高，与睾酮治疗比较组观察到的抑制相反。据报道，在肥胖或性腺功能低下的男性中，精液参数有所改善；然而，在健康个体中没有发现明显的变化。结论：GLP-1RAs可能在维持促性腺激素功能的同时，提高代谢问题男性的睾丸激素水平，并可能提高精液质量。在一些与肥胖相关的性腺功能减退病例中，它们可以作为睾酮治疗的生育保护替代方案。需要对标准化生育措施进行更长期的对照研究，以确认它们在男性生殖健康中的作用。
{"title":"Effects of glucagon-like peptide-1 receptor agonists on male reproductive hormones, semen parameters, and metabolic outcomes: a systematic review.","authors":"Mohammad Ghassab Deameh, Mohamed Ramez, Rashed Rowaiee, Baha' Aldeen Bani Irshid, Hamza Mohamed, Abdelrahman Abdelshafi, Mohammad Ali Al-Osoufi, Tarek Mohamed, Safa Botros Hegazin, Omer Raheem","doi":"10.1093/jsxmed/qdaf381","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf381","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are antidiabetic agents that also induce weight loss. Their widespread use has prompted investigation of potential benefits beyond glycemic control, including effects on male sexual and reproductive function. Emerging evidence suggests that they may improve male reproductive parameters, particularly in men with metabolic dysfunction.</p><p><strong>Objectives: </strong>To systematically evaluate the effects of GLP-1RAs (liraglutide, semaglutide, dulaglutide, and exenatide) on male reproductive hormones, semen parameters, and metabolic outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched in PubMed, Embase, Scopus, and Web of Science up to April 2025. Eligible studies included randomized controlled trials (RCTs) and cohort studies evaluating the effects of GLP-1RAs in adult men. Assessed the risk of bias with the risk of bias 2 tool for RCT and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool for observational studies.</p><p><strong>Results: </strong>Ten studies involving a total of 639 men were included. GLP-1RAs were consistently associated with increased total testosterone, particularly in men with obesity, type 2 diabetes, or functional hypogonadism. Free testosterone changes were inconsistent, often offset by concurrent rises in sex hormone-binding globulin. Luteinizing hormone and follicle-stimulating hormone levels were preserved or increased with GLP-1RA use, in contrast to the suppression observed in testosterone therapy comparator groups. Improvements in semen parameters were reported in obese or hypogonadal men; however, no significant changes were found in healthy individuals.</p><p><strong>Conclusion: </strong>GLP-1RAs may improve testosterone levels and potentially enhance semen quality in men with metabolic issues, while maintaining gonadotropin function. They could serve as fertility-sparing alternatives to testosterone therapy in some obesity-related hypogonadism cases. More long-term, controlled studies with standardized fertility measures are needed to confirm their role in male reproductive health.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to Letter to the Editor on \"Renal health and erectile dysfunction in adult men: insights from the National Health and Nutrition Examination Survey data\".","authors":"Renjie Huang, Miao Huang, Rui Zhang","doi":"10.1093/jsxmed/qdaf377","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf377","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Colombo, Jiangping Deng, Ervin Kocjancic, Omer Acar, Daniel A Harrington, Kevin T McVary, Carol A Podlasek
<p><strong>Background: </strong>Tunica albuginea plays a critical role in the biomechanics of the penis, as the main bearer of mechanical forces during erection; collagen is central to changes that occur in the tunica of Peyronie's patients; however, our understanding of tunica collagen composition remains poorly understood.</p><p><strong>Aim: </strong>To quantify collagen abundance and subtypes in tunica and corpora cavernosa of reconstruction patients treated with 0-25 years of 17β-estradiol and Spironolactone.</p><p><strong>Methods: </strong>Tunica and corpora cavernosa (n = 25) were obtained from patients undergoing penectomy with reconstruction surgery. Collagen was quantified and evaluated with 17β-estradiol treatment, age, antiandrogen, and testosterone concentration. Immunohistochemistry (IHC) for collagen I-IV was performed with ImageJ quantification. Primary tunica cell cultures were established and characterized for P4HB (fibroblast), α-ACTIN (smooth muscle), and CD31 (endothelium). Fibroblast growth with Sonic hedgehog (SHH), BMP4, and GREM1 treatment were quantified.</p><p><strong>Outcomes: </strong>Hydroxyproline, IHC, and cell culture were performed.</p><p><strong>Results: </strong>Collagen abundance did not correlate with duration of 17β-estradiol and antiandrogen treatment, age, and testosterone level. Collagen III was more abundant in the corpora cavernosa than the tunica, and collagen III increased 35.4% (P = .05) in tunica of patients treated with 17β-estradiol and antiandrogen, mimicking the increased collagen III observed in Peyronie's patients. Collagen I was 12.1% higher in the corpora cavernosa than the tunica (P = .049) and was unchanged in tunica (P = .34) and corpora cavernosa (P = .41) with 17β-estradiol and antiandrogen treatment. Collagen IV increased 26.6% in corpora cavernosa with 17β-estradiol and antiandrogen treatment (P = .005). P4HB staining fibroblasts were isolated from patient tunica; fibroblasts increased growth with GREM1 and decreased growth with BMP4.</p><p><strong>Clinical implications: </strong>Reconstruction patients develop Peyronie's-like changes in collagen subtypes (collagen III) in the tunica that offer a unique opportunity to study how collagen signaling becomes dysfunctional and provide novel insight into early-stage collagen changes.</p><p><strong>Strengths and limitations: </strong>Collagen III increased in tunica of reconstruction patients. It is of interest that tunica of reconstruction patients, which do not display a plaque as in Peyronie's patients, show a similar change in collagen III abundance. It is unclear how changes in collagen subtype impact erectile function.</p><p><strong>Conclusion: </strong>In addition to 17β-estradiol and antiandrogen treatment, reconstruction patients practice aggressive taping and compression of their tissue, which may induce Peyronie's-like collagen changes from the repeated microtrauma and/or ischemia; reconstruction patient tunica may provide a novel
{"title":"Peyronie's-like changes in the tunica albuginea were identified in reconstruction patients.","authors":"Alberto Colombo, Jiangping Deng, Ervin Kocjancic, Omer Acar, Daniel A Harrington, Kevin T McVary, Carol A Podlasek","doi":"10.1093/jsxmed/qdaf387","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf387","url":null,"abstract":"<p><strong>Background: </strong>Tunica albuginea plays a critical role in the biomechanics of the penis, as the main bearer of mechanical forces during erection; collagen is central to changes that occur in the tunica of Peyronie's patients; however, our understanding of tunica collagen composition remains poorly understood.</p><p><strong>Aim: </strong>To quantify collagen abundance and subtypes in tunica and corpora cavernosa of reconstruction patients treated with 0-25 years of 17β-estradiol and Spironolactone.</p><p><strong>Methods: </strong>Tunica and corpora cavernosa (n = 25) were obtained from patients undergoing penectomy with reconstruction surgery. Collagen was quantified and evaluated with 17β-estradiol treatment, age, antiandrogen, and testosterone concentration. Immunohistochemistry (IHC) for collagen I-IV was performed with ImageJ quantification. Primary tunica cell cultures were established and characterized for P4HB (fibroblast), α-ACTIN (smooth muscle), and CD31 (endothelium). Fibroblast growth with Sonic hedgehog (SHH), BMP4, and GREM1 treatment were quantified.</p><p><strong>Outcomes: </strong>Hydroxyproline, IHC, and cell culture were performed.</p><p><strong>Results: </strong>Collagen abundance did not correlate with duration of 17β-estradiol and antiandrogen treatment, age, and testosterone level. Collagen III was more abundant in the corpora cavernosa than the tunica, and collagen III increased 35.4% (P = .05) in tunica of patients treated with 17β-estradiol and antiandrogen, mimicking the increased collagen III observed in Peyronie's patients. Collagen I was 12.1% higher in the corpora cavernosa than the tunica (P = .049) and was unchanged in tunica (P = .34) and corpora cavernosa (P = .41) with 17β-estradiol and antiandrogen treatment. Collagen IV increased 26.6% in corpora cavernosa with 17β-estradiol and antiandrogen treatment (P = .005). P4HB staining fibroblasts were isolated from patient tunica; fibroblasts increased growth with GREM1 and decreased growth with BMP4.</p><p><strong>Clinical implications: </strong>Reconstruction patients develop Peyronie's-like changes in collagen subtypes (collagen III) in the tunica that offer a unique opportunity to study how collagen signaling becomes dysfunctional and provide novel insight into early-stage collagen changes.</p><p><strong>Strengths and limitations: </strong>Collagen III increased in tunica of reconstruction patients. It is of interest that tunica of reconstruction patients, which do not display a plaque as in Peyronie's patients, show a similar change in collagen III abundance. It is unclear how changes in collagen subtype impact erectile function.</p><p><strong>Conclusion: </strong>In addition to 17β-estradiol and antiandrogen treatment, reconstruction patients practice aggressive taping and compression of their tissue, which may induce Peyronie's-like collagen changes from the repeated microtrauma and/or ischemia; reconstruction patient tunica may provide a novel ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor on \"Improved health-related quality of life and gender congruence after gender-affirming mastectomy: a prospective cohort study\".","authors":"Shyam Sundar Sah, Abhishek Kumbhalwar","doi":"10.1093/jsxmed/qdaf380","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf380","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor on \"The association between dietary vitamin E intake and erectile dysfunction in adults: analyses of NHANES and Mendelian randomization\".","authors":"Jianguo Xu, Zhongyan Chen, Weiwei Lai","doi":"10.1093/jsxmed/qdaf393","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf393","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seetha H Davis, Sarah Martinez, Tiffany Minors Fulton, Huma Farid, Sara McKinney
{"title":"Barriers to specialty care among patients with vulvovaginal symptoms: findings from a retrospective cohort of vulvovaginal clinic patients.","authors":"Seetha H Davis, Sarah Martinez, Tiffany Minors Fulton, Huma Farid, Sara McKinney","doi":"10.1093/jsxmed/qdag010","DOIUrl":"10.1093/jsxmed/qdag010","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel J Huynh, Casey St Luce, Neil Shah, Nikki Duong
{"title":"Association between erectile dysfunction and cirrhosis severity: a 9-year real-world data analysis.","authors":"Daniel J Huynh, Casey St Luce, Neil Shah, Nikki Duong","doi":"10.1093/jsxmed/qdaf373","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf373","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between the interval from menarche to first sexual intercourse and mental and sexual health outcomes in US women: National Health and Nutrition Examination Survey 2005-2016.","authors":"Renjie Huang, Miao Huang, Rui Zhang","doi":"10.1093/jsxmed/qdaf390","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf390","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 2","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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