Journal of diabetes and its complicationsJul 4, 2025

Tirzepatide and its link to erectile problems in people with type 2 diabetes

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jan 20, 2026

Abstract

Tirzepatide was associated with a significantly reduced risk of developing erectile dysfunction in men with type 2 diabetes compared to other treatments.

Risk ratios indicated that men on tirzepatide had a 30% lower risk of ED compared to sitagliptin.
The risk of ED was 33% lower for tirzepatide compared to injectable semaglutide.
Tirzepatide showed a 45% reduced risk of ED when compared to dulaglutide.
All comparisons made were statistically significant, suggesting a consistent association across different treatment options.

Simplified

AIMS: To evaluate the association between tirzepatide and the risk of developing erectile dysfunction (ED) in men with type 2 diabetes (T2D), compared with sitagliptin, injectable semaglutide, and dulaglutide.

METHODS: This retrospective cohort study used the TriNetX global health research network from May 13, 2022 to May 17, 2025. Male patients aged 18-70 with T2D and no prior ED were included. Three 1:1 propensity score-matched comparisons were conducted: tirzepatide vs. sitagliptin, injectable semaglutide, or dulaglutide. The outcome was a diagnosis of ED or prescription of a PDE-5 inhibitor.

RESULTS: Tirzepatide was associated with a significantly reduced risk of ED across all comparisons. Risk ratios (RR) for the composite outcome of ED diagnosis or PDE-5 inhibitor use were: tirzepatide vs. sitagliptin: RR, 0.70 (95 % CI: 0.64,0.76); tirzepatide vs. injectable semaglutide: RR, 0.67 (95 % CI: 0.62,0.72); tirzepatide vs. dulaglutide: RR, 0.55 (95 % CI: 0.51,0.59). All comparisons were statistically significant (p < 0.001).

CONCLUSIONS: Tirzepatide was associated with a lower risk of ED in men with T2D compared to sitagliptin, injectable semaglutide, and dulaglutide. Randomized trials are needed to confirm these findings and explore potential mechanisms.

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Tirzepatide and its link to erectile problems in people with type 2 diabetes

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