Wegovy (semaglutide 2.4 mg) is a GLP-1 receptor agonist licensed in the UK for weight management in adults with obesity or those who are overweight with weight-related conditions. Whilst sexual dysfunction is not listed as an adverse reaction in the Summary of Product Characteristics, some patients have raised concerns about changes in sexual function during treatment. This article examines the potential indirect mechanisms through which Wegovy and weight loss may influence sexual health, provides practical management strategies, and clarifies when to seek medical advice. Understanding these factors helps patients and healthcare professionals optimise both weight management outcomes and overall quality of life.

What Is Wegovy and How Does It Work?

Wegovy (semaglutide 2.4 mg) is a prescription medication licensed in the UK for weight management in adults with obesity or those who are overweight with weight-related health conditions. It belongs to a class of medicines called GLP-1 receptor agonists, which were originally developed for type 2 diabetes management but have proven highly effective for weight loss.

The medication works by mimicking a naturally occurring hormone called glucagon-like peptide-1 (GLP-1). This hormone plays several important roles in regulating appetite and metabolism:

• Slows gastric emptying, helping you feel fuller for longer after meals

• Reduces appetite by acting on areas of the brain that control hunger

• Improves blood sugar control by stimulating insulin release when blood glucose levels rise

• Decreases glucagon secretion, which helps prevent excess glucose production by the liver

Wegovy is administered as a once-weekly subcutaneous injection, typically in the abdomen, thigh, or upper arm. The dose is gradually increased over several weeks according to a specific schedule to minimise gastrointestinal side effects and allow the body to adjust. When combined with a reduced-calorie diet and increased physical activity, clinical trials (primarily the STEP 1 trial in adults without diabetes) have shown that Wegovy can help patients lose an average of 12–15% of their body weight over 68 weeks, though individual results vary.

Importantly, Wegovy is contraindicated during pregnancy and breastfeeding. Women of childbearing potential should use effective contraception while taking Wegovy and stop treatment at least 2 months before a planned pregnancy, as weight loss may increase fertility.

The medication is available through the NHS for eligible patients meeting specific criteria, including a body mass index (BMI) of 35 kg/m² or above (or 32.5 kg/m² for people from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean backgrounds). NHS treatment is provided only through specialist weight management services and for a maximum duration of 2 years, as per NICE guidance. Private prescriptions are also available through registered healthcare providers following appropriate assessment.

Why Weight Loss Medications May Affect Sexual Function

Concerns about sexual side effects with Wegovy have emerged in patient forums and social media, though sexual dysfunction is not listed as an adverse reaction in the Wegovy Summary of Product Characteristics (SmPC). Evidence for a direct causal link is limited, though pharmacovigilance monitoring continues. Understanding the potential indirect mechanisms is important for patients and healthcare professionals.

Weight loss itself can influence sexual function in complex ways. Significant weight reduction often improves cardiovascular health, hormone balance, and self-confidence—factors that typically enhance sexual wellbeing. However, rapid weight loss may temporarily affect:

• Hormone levels: Fat tissue produces oestrogen, and substantial fat loss can alter sex hormone balance. This often leads to positive effects, such as improved testosterone levels in men and better reproductive parameters in women with polycystic ovary syndrome (PCOS)

• Energy levels: Caloric restriction and metabolic changes may cause fatigue, potentially affecting libido

• Body image adjustment: Psychological adaptation to a changing body can temporarily impact intimate relationships

• Nutritional status: Inadequate nutrient intake during weight loss may affect overall vitality

Gastrointestinal side effects associated with Wegovy—including nausea, vomiting, diarrhoea, and abdominal discomfort—are common, particularly during dose escalation. According to the SmPC, nausea affects approximately 43% of patients, though this typically improves over time. These symptoms may indirectly reduce interest in sexual activity due to general malaise or discomfort.

Psychological factors also warrant consideration. The stress of lifestyle changes, medication management, and body transformation can affect mood and relationships. Some patients report changes in their relationship with pleasure and reward, including food and potentially other activities, though this varies considerably between individuals. It's worth noting that obesity itself is associated with higher rates of sexual dysfunction, and many patients report improvements in sexual health following successful weight loss, once they've adjusted to their new weight and the medication has stabilised.

Managing Sexual Health While Taking Wegovy

If you're experiencing changes in sexual function whilst taking Wegovy, several practical strategies can help you maintain sexual wellbeing during your weight loss journey.

Optimise your nutrition and hydration:

• Ensure adequate protein intake to maintain muscle mass and energy—consider discussing your specific needs with a registered dietitian, particularly if you have kidney disease

• Stay well-hydrated, as dehydration can worsen fatigue and gastrointestinal symptoms

• If considering supplements, discuss with your healthcare provider first to ensure they're appropriate and won't exceed recommended daily allowances

• Eat small, frequent meals to manage nausea and maintain stable energy levels

Consider medication timing. Some patients find that gastrointestinal side effects may be more noticeable in the days following injection, though this varies between individuals. If you notice a pattern, you might discuss with your prescriber whether adjusting your weekly dose schedule could help minimise impact on planned intimate occasions, ensuring this aligns with your treatment plan.

Communicate openly with your partner about the physical and emotional changes you're experiencing. Weight loss journeys can affect relationships, and maintaining honest dialogue helps partners understand and support each other. Consider that your partner may also be adjusting to changes in your appearance and health status.

Prioritise overall wellbeing:

• Maintain regular physical activity, which improves cardiovascular health, mood, and sexual function

• Ensure adequate sleep (7–9 hours nightly), as sleep deprivation significantly impacts libido

• Manage stress through relaxation techniques, mindfulness, or counselling if needed

• Allow time for physical intimacy even when spontaneous desire is reduced—responsive desire often develops during intimate activity

Be aware of contraception needs. Weight loss may increase fertility, and Wegovy is contraindicated in pregnancy and during breastfeeding. Use effective contraception while taking Wegovy and for at least 2 months after stopping treatment if pregnancy is possible. Note that significant vomiting or diarrhoea may reduce the effectiveness of oral contraceptive pills—follow missed pill guidance or use additional contraception if this occurs.

Monitor for underlying conditions. If sexual difficulties persist beyond the initial adjustment period (typically 3–6 months), consider whether other factors might be contributing, such as undiagnosed diabetes complications, cardiovascular disease, or hormonal imbalances. Weight loss can unmask or improve these conditions, making reassessment valuable.

When to Speak to Your GP About Side Effects

Knowing when to seek medical advice is crucial for safe and effective treatment with Wegovy. Contact your GP or prescribing clinician if:

Sexual health concerns are significantly affecting your quality of life or relationships. Your doctor can assess whether the changes are likely related to Wegovy, weight loss, or other factors. They may recommend:

• Blood tests to check hormone levels (testosterone, oestrogen, thyroid function)

• Cardiovascular assessment if erectile dysfunction is present (this can be an early sign of heart disease)

• Referral to specialist services for sexual health or relationship counselling

• Medication review to identify other drugs that might contribute to sexual dysfunction

You experience mood changes, depression, or thoughts of self-harm. While a direct causal relationship hasn't been established, the SmPC advises monitoring for mood changes and suicidal thoughts. Seek urgent help if you experience these symptoms and discuss whether to continue treatment with your prescriber.

You develop severe or persistent gastrointestinal symptoms that don't improve with dose adjustment or supportive measures. Uncontrolled nausea, vomiting, or diarrhoea can lead to dehydration and nutritional deficiencies, indirectly affecting all aspects of health including sexual function.

Seek urgent medical attention if you experience:

• Severe, persistent abdominal pain (which may radiate to your back) with or without vomiting—this could indicate pancreatitis

• Pain in the right upper abdomen, yellowing of skin/eyes, fever—possible signs of gallbladder disease

• Signs of severe dehydration or allergic reactions

You notice signs of excessive weight loss, extreme fatigue, hair loss, or other concerning symptoms. These may indicate inadequate nutrition or other medical issues requiring assessment.

You're considering stopping Wegovy due to side effects. Your GP can discuss alternative approaches, dose adjustments, or temporary treatment breaks. Abruptly stopping the medication often leads to weight regain, so a planned approach is preferable.

Remember that NICE guidelines emphasise individualised care for weight management. Your treatment plan should be regularly reviewed according to your local service protocol, with NHS treatment typically limited to a maximum of 2 years. Sexual health is a legitimate component of quality of life and should be part of these discussions. Most side effects improve with time, and many patients find that the overall health benefits of weight loss ultimately enhance their sexual wellbeing and intimate relationships.

If you suspect you're experiencing side effects from Wegovy, you can report them through the MHRA Yellow Card scheme, which helps monitor medication safety.

Frequently Asked Questions