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Male Sexual and Reproductive Health in Diabetes and Obesity Pharmacotherapy: A Source-Triangulated Counseling Map
Marek Broul1,2,3, Michal Dubský4,5, Aneta Hujová3
1Department of Sexology, Krajská Zdravotní, a.s.-Masaryk Hospital in Ústí nad Labem, o.z., Ústí nad Labem, Czech Republic.
Background:
Drugs used for diabetes and obesity increasingly shape male sexual and reproductive counseling, but clinical studies, trial registrations, regulatory labels, and patents answer different questions.
Objectives:
The objective is to map these sources and define what each can support when counseling men receiving metabolic drugs.
Materials And Methods:
We reviewed human studies, ClinicalTrials.gov records, FDA/EMA labels, and selected patent or pipeline documents using source-specific eligibility criteria and evidence rules.
Results:
Human evidence is concentrated around glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dual GLP-1/GIP receptor agonism, SGLT2 inhibitors, and metformin or paternal exposure. Direct fertility and live-birth data remain sparse. Trial registries include more male reproductive endpoints than published studies report. Regulatory labels mainly inform genital-safety counseling and nonclinical reproductive toxicology language. Patents contain erectile and male reproductive claims, but these claims are not clinical evidence.
Discussion And Conclusion:
Counseling should separate genital safety, endocrine and sexual-function signals, semen and fertility outcomes, and paternal-exposure concerns. Hormonal, sexual-function, or semen changes may track metabolic recovery; they do not establish improved conception or live birth. These drugs should be selected for metabolic indications, not as treatments for ED or infertility.
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