GLP-1s and Desire: How Body Changes Shape Confidence, Connection, and Intimacy

​​Written by Sexual Wellness Institute Owner and Therapist, Amanda Holmberg, MS LMFT

When someone begins a GLP-1 medication like semaglutide or tirzepatide, they usually expect changes in their body, appetite, or other health markers. What many do not expect is that these shifts can also influence sexual desire, confidence in the body, and intimacy within relationships. This post explores how body changes relate to desire, what current research suggests, and how to nurture confidence and pleasure when things feel different.
It is important to emphasize that changes in desire or sexual well-being are not universal. For some people, GLP-1s enhance confidence and energy. For others, they can bring temporary disconnection or new vulnerabilities. If sexual changes occur, they can often be addressed directly, just as they would be with any other medication that affects libido.

Why This Conversation Matters

The emotional and sexual effects of GLP-1s are rarely discussed in medical settings, yet many people notice subtle shifts in how they feel in their bodies and in their intimate relationships. Sexuality is often the missing piece in conversations about health, but it deserves the same care as physical and emotional well-being. Talking about these experiences helps normalize them and allows people to seek support instead of feeling isolated or confused.

The Relationship Between Body Experience and Sexual Desire

Body Image as a Key Factor
How someone feels about their body strongly influences sexual function and satisfaction. Feeling at ease, confident, and self-accepting can make it easier to access desire and pleasure.
As the body changes, it can take time to feel fully at home again. Reconnecting with how the body feels, rather than how it looks, often helps desire grow naturally.

What the Research Says About GLP-1s and Sexual Function

Current research on GLP-1 medications and sexual functioning is mixed. Some people notice improvements in confidence or sexual energy, while others report a temporary decrease in desire or arousal. The science is still developing, and results vary widely from person to person.
Like with any medication that impacts sexual functioning, each contributing factor can be explored and treated. Talk with your doctor about any changes you notice in desire, arousal, or comfort. Some of these issues can be addressed medically, whether through adjusting timing, managing side effects, or supporting hormone balance. Therapy can also help address the psychological or relational aspects that often accompany physical change. With a collaborative approach, many people are able to restore a sense of connection and pleasure.

Strategies to Cultivate Confidence and Support Desire

1. Normalize the Possibility and Address It Directly
Recognize that changes in sexual desire can happen for many reasons, including medication. If you notice a shift, talk openly with your provider and your therapist. Often, a combination of medical and emotional support helps you feel more grounded and confident.
2. Reconnect with Your Body
Gentle movement, touch, or mindfulness can rebuild familiarity. Practices such as stretching, yoga, or body scanning can help you feel more connected and present. When you begin to experience your body as capable and alive, confidence often follows.
3. Notice Positive Changes in the Body
As you reconnect, notice what feels better or easier now. You might have steadier energy, less bloating, or greater emotional balance. These shifts are worth recognizing. Gratitude for small improvements can strengthen trust in your body and make pleasure easier to access.
4. Explore Sensation
Focus on physical sensations without pressure for performance. Pay attention to areas of your body that you appreciate or feel stronger in, such as your legs, arms, or breath. Allow curiosity about how sensations feel different now. Pleasure can grow from self-appreciation and respect for what your body can do.
5. Communicate with Partners
Share what feels good, what feels different, or what feels off-limits for now. Honest, kind communication reduces pressure and increases closeness. Partners who understand what is happening can meet you with empathy and care.
6. Seek Professional Support
A sex therapist can help you identify the emotional, relational, and psychological factors that influence desire. Therapy can provide a supportive space to talk through changes and develop tools for reconnecting with your body and your partner.
7. Expand Definitions of Pleasure
Pleasure does not have to be sexual to matter. Enjoying music, creativity, laughter, or time in nature strengthens your capacity for joy and self-connection, which supports sexual wellbeing too.
8. Practice Patience and Self-Compassion
Desire naturally fluctuates. It may take time to adjust to changes in your body or energy. Being gentle with yourself makes it easier for curiosity and pleasure to return.

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Reclaiming Connection

Sexuality is an evolving part of health, not a fixed trait. As your body changes, the relationship you have with yourself may shift, too. GLP-1s can bring more comfort and vitality, or they may create moments of unfamiliarity. Both experiences are valid. What matters most is staying curious about your body’s cues and allowing yourself to rediscover pleasure in ways that feel safe, real, and uniquely your own.

Key Takeaways About GLP-1 Medications, Sexual Desire, and Body Image

• GLP-1 medications can influence sexual desire for some people, though effects vary widely.
• Current research is mixed on whether GLP-1s enhance or reduce sexual function.
• Like with any medication that affects sexual functioning, each factor can be explored and treated through medical and therapeutic support.
• Body changes can temporarily alter comfort or confidence, but these effects are often reversible.
• Noticing positive changes supports body connection and confidence.
• Open communication, mindfulness, and therapy can help restore intimacy and desire.
• Sexual wellbeing deserves the same care as every other aspect of health.

Series Note

This post is the second in a three-part series on GLP-1s, body confidence, and intimacy. The next article will explore how relationships can shift when one partner is taking a GLP-1 and the other is not, and how couples can stay emotionally and sexually connected through change.

Consider Sex Therapy Near Minneapolis, MN

At Sexual Wellness Institute, we support anyone who would like help in exploring intimacy with compassion and without shame. Whether you are navigating body changes, desire shifts, or relationship dynamics while on a GLP-1, our therapists can help you strengthen both your confidence and your connection. To get started, simply:

1. Contact the Sexual Wellness Institute to set up your first appointment.
2. Meet with one of our skilled sex and relationship therapists for an intake appointment.
3. Move forward with joy and fulfillment in sex and relationships! 

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About the Author: Sex Therapist Amanda Holmberg

Amanda Holmberg, MS LMFT, is a licensed marriage and family therapist, sex therapist, and AAMFT-Approved Supervisor with more than 15 years of experience specializing in sex and relationship therapy. She is the founder of Sexual Wellness Institute and Radiant Living Therapy, where she helps individuals and couples address sexual concerns, intimacy challenges, and relationship dynamics in a stigma-free and trauma-aware environment. Amanda also provides training and supervision for therapists, creating tools and resources to strengthen supervision and clinical skills for therapists. ​

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Other Mental Health Services in Minnesota

​In addition to sex therapy, our LGBT & polyamory friendly sex therapists provide a wide range of mental health services at our Plymouth, MN counseling office. Other services include couples therapy & marriage counseling, EFT, evidence-based couples therapy, EMDR & sexual trauma therapy, as well as teen therapy. In order to help serve the mental health needs of all those living in Minnesota, we also offer online counseling & sex therapy. We also provide a variety of helpful tips on our mental health blog. Please feel free to reach out with questions, or if you would like to schedule an appointment to begin working with a skilled sex therapist! Your sex life can be amazing. Sex therapy can be a part of that process for you.

References:

• Li, D., & Chen, Z. (2024). Tirzepatide-induced sexual dysfunction in women: A case report. Journal of Clinical Pharmacology and Therapeutics, 59(3), 217–220. 
• Liu, X., & Zhou, J. (2024). GLP-1 receptor agonists and female sexual function: Potential mechanisms and clinical implications. Frontiers in Endocrinology, 15, Article 11202225. 
• Maia, A. C. C. O., & Gomes, H. A. (2021). Body image and its relationship with sexual function and quality of life in postmenopausal women. BMC Women’s Health, 21(1), 349. 
• Zhou, H., Liu, R., & Wang, Y. (2024). Long-acting GLP-1 receptor agonists may improve endothelial function: A review. Frontiers in Endocrinology, 15, Article 1448394.