Mohammed Ghada Farouk, Al-Dhubaibi Mohammed Saleh, Bahaj Saleh Salem, Mohammed Rana Magdy
Department of Dermatology, Venereology and Sexology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Dermatology, Department of Medicine, College of Medicine, Shaqra University, Dawadmi, Saudi Arabia.
Clin Med Insights Case Rep. 2025 Jun 6;18:11795476251347753. doi: 10.1177/11795476251347753. eCollection 2025.
Tirzepatide is a new molecule capable of controlling blood glucose levels by combining the dual agonism of glucose-dependent insulinotropic polypeptide (GIP) and glucose-like peptide-1 (GLP-1) receptors. The Food and Drug Administration approved tirzepatide subcutaneous injections as monotherapy or combination therapy, with diet and physical exercise. Its influence on sexual behavior as an adverse effect is not well known.
The purpose of this report was to present a case study of an obese female patient who received tirzepatide treatment for sexual dysfunction.
We performed an extensive clinical evaluation, which included the Female Sexual Function Index (FSFI). Metabolic, hormonal, immunologic, and hematologic etiology of sexual dysfunction was ruled out by laboratory examination. The patient was managed by a multimodal approach, with lifestyle modification, pelvic floor strengthening exercises, pharmacologic management with bupropion sustained release 150 to 400 mg per day and topical lubricants, and psychosexual therapy as needed. FSFI scores were longitudinally followed to assess treatment response.
A 36-year-old woman with obesity class III developed sexual dysfunction after using tirzepatide, a healthy lifestyle with a carb cycle diet, greater physical activity, and exercise for losing weight. All physical, psychological, and hormonal parameters were normal. During treatment, the patient started to complain of decreasing sexual drive, genital dryness, and failure to catch orgasm; female sexual function index (FSFI) = 12.7. Symptoms decreased after stopping the tirzepetide (FSFI = 28.7) and reappeared after retaking the injection (FSFI = 14.7). After 1 month of sexual treatment and support, FSFI = 24.
The drug's impact on hormones and neurological pathways may contribute to decreased sexual desire, through the specific process is unknown. Adjuvant sexual education and therapy support has an imperative role in the plan of management in cases on going in the journey of reducing their weight and complaining of sexual performance affection.
替尔泊肽是一种新型分子，能够通过结合葡萄糖依赖性促胰岛素多肽（GIP）和胰高血糖素样肽-1（GLP-1）受体的双重激动作用来控制血糖水平。美国食品药品监督管理局批准替尔泊肽皮下注射作为单一疗法或联合疗法，配合饮食和体育锻炼使用。其作为不良反应对性行为的影响尚不明确。
本报告旨在介绍一例接受替尔泊肽治疗性功能障碍的肥胖女性患者的病例研究。
我们进行了全面的临床评估，包括女性性功能指数（FSFI）。通过实验室检查排除了性功能障碍的代谢、激素、免疫和血液学病因。患者采用多模式方法进行管理，包括生活方式改变、盆底强化锻炼、每天150至400毫克缓释安非他酮和局部润滑剂的药物治疗，以及必要时的性心理治疗。纵向跟踪FSFI评分以评估治疗反应。
一名患有III级肥胖的36岁女性在使用替尔泊肽、采用健康的碳水循环饮食生活方式、增加体育活动和进行减肥锻炼后出现性功能障碍。所有身体、心理和激素参数均正常。治疗期间，患者开始抱怨性欲下降、生殖器干燥和无法达到性高潮；女性性功能指数（FSFI）=12.7。停用替尔泊肽后症状减轻（FSFI=28.7），重新注射后症状再次出现（FSFI=14.7）。经过1个月的性治疗和支持后，FSFI=24。
该药物对激素和神经通路的影响可能导致性欲下降，具体过程尚不清楚。在体重减轻且抱怨性功能受影响的患者管理计划中，辅助性性教育和治疗支持起着至关重要的作用。
