Real-World Data Reveals Sexual Side Effects of Common Antidiabetic Drugs

Diabetes mellitus is a chronic metabolic disease often associated with various complications, including sexual dysfunction in both men and women. While antidiabetic medications are crucial for managing blood glucose, their potential impact on sexual health is not always systematically evaluated in clinical trials. This study addresses the crucial gap in understanding the specific sexual safety profiles of common antidiabetic drugs using large-scale, real-world adverse event data.

The analysis identified several significant sexual safety signals across different antidiabetic drug classes. Sulfonylureas showed a 3.1-fold higher reporting odds ratio (ROR) for erectile dysfunction (p<0.0001) compared to other drugs, indicating a strong signal. SGLT2 inhibitors were associated with a 2.3-fold increased ROR for decreased libido (p<0.001), particularly in female patients, and a 1.8-fold increased ROR for genital pruritus (p=0.003) which can impact sexual comfort. In contrast, metformin did not show any significant disproportionality signals for sexual adverse events. GLP-1 receptor agonists presented a 1.5-fold increased ROR for ejaculatory dysfunction (p=0.02) in male patients. Overall, 43% of all sexual adverse event reports linked to antidiabetic drugs were associated with sulfonylureas and SGLT2 inhibitors combined. The most significant finding was a 3.1-fold increased reporting odds ratio for erectile dysfunction associated with sulfonylureas (p<0.0001) compared to non-diabetic controls, suggesting a strong and previously underappreciated safety signal.