Welcome to The Thin Line, The New York Post’s series about the darker side of GLP-1 drugs. Though GLP-1 agonists sold under brand names like Ozempic have helped millions of people lose weight, manage diabetes and improve other health conditions, they are not without risks. Check back for more stories about the lesser-known downsides of these wildly popular medications.
Christine Reed-Smith had tried it all: a dietitian, grueling workouts, even weight-loss surgery in Mexico. Yet the pounds kept creeping up, and her body was becoming insulin resistant.
So at 50, the salon owner from Columbia City, Oregon, turned to tirzepatide, the active ingredient in GLP-1 drugs like Mounjaro and Zepbound, hoping to rein in her blood sugar and finally stabilize the scale.
Ultimately, she got the body she wanted — but weight wasn’t the only thing she lost.
“All of a sudden, I couldn’t care less about sex,” Reed-Smith told The Post.
Reed-Smith’s sex life with her husband had ups and downs over their 17-year marriage — not uncommon for a long-term relationship. Usually, she was the one keeping things spicy — but after starting a GLP-1, her libido tanked.
“I would participate, but I definitely wouldn’t climax, or if I did, it took a lot of effort. And I feel guilty for that because it isn’t due to poor performance on my husband’s part,” she said. “It’s literally that something is wrong with me.”
The problem went beyond the bedroom.
“When you go from having a very active sex life to having a nonexistent sex life, there was a lot of silence,” Reed-Smith said. “There were cold shoulders. There were hurt feelings — probably from both of us.”
How GLP-1s can affect libido
GLP-1s help regulate appetite and blood sugar by mimicking hormones released by the gut after eating — but they can also affect the brain and body in unexpected ways. For some, the changes can dampen libido.
“Fewer signals are being sent to your brain to seek out pleasure, and sexual motivation just doesn’t happen,” explained Dr. James Chao, co-founder and chief medical officer of VedaNu Wellness in San Diego, who treats patients taking the weight-loss drugs.
It doesn’t affect everyone the same way — in fact, he points out, some report more sexual desire after weight loss: “Moving feels good again. Clothes fit. They can look in the mirror without loathing. That visual dopamine hit coupled with decreased cortisol can kick libido into overdrive for some people.”
That has been CJ Rock’s experience before GLP-1s.
“In the past, if I had lost weight, I got a self-esteem boost, which is almost like dopamine. It makes you crave sex more,” the 47-year-old explained. But when she started taking tirzepatide, her libido dropped.
“My sex drive was normal, two or three times a week. I had the craving and the desire,” she said — but then, suddenly, it was gone.
“Five months in, I didn’t even want my husband to come near me. Like ‘No, stop, I don’t even want to kiss you.’”
Nathalia Souza
She had lost 70 pounds in seven months and was feeling good in her skin. But when her fiancé tried the moves that used to turn her on, her body didn’t respond.
“I was almost numb to it,” she said. “There would be nights where I’d wonder what was wrong with me.”
Chao said this fits a pattern. Rapid weight loss like that spurred by GLP-1s can sometimes push the body into “conservation mode” as it adapts to having less available fuel.
“Since libido is categorized as a ‘want’ and not a ‘need,’ your brain will often suppress it until things come back in balance,” he explained.
The menopause transition only added to the challenge, as both Rock and Reed-Smith had to untangle the overlapping effects of hormones, aging and medication on their libido.
“It’s very hard because when you start perimenopause, your sex drive is one of the main things that goes,” Rock said.
“A lot of doctors don’t recognize it with women at all, so here you have all these women on this drug and it’s making them healthier, but they’re going through this too,” she continued. “It’s just so confusing, like picking your poison.”
From ‘very high sex drive’ — to no desire at all
But the changes in libido aren’t limited to women navigating menopause.
Nathalia Souza, a 37-year-old from New Jersey, started taking tirzepatide after three years of dieting and exercising resulted in just 30 pounds of weight loss.
In the seven months since starting the medication, Souza has dropped another 22 pounds — and overall, she calls the experience a success. But there was one unexpected downside.
“I had a very high sex drive, and probably two months in, I noticed I had no desire anymore,” Souza said.
The change was stark. Before the drug, she and her husband were having sex four or five times a week.
“Five months in, I didn’t even want my husband to come near me,” Souza said. “Like ‘No, stop, I don’t even want to kiss you.’”
How they got their groove back
The abrupt shift in Souza’s sex drive left her shaken, making her question whether the weight-loss drug was worth it.
“This is where I draw the line,” she said. “I’m not losing my marriage over this.”
Before giving up on the meds, she stocked up on supplements — vitamin D, magnesium, creatine and maca root — but nothing worked.
“I would rather be in this body than be sexually active. What does that say about me? I don’t know.”
Christine Reed-Smith
Then she discovered URO Vaginal Moisture & Mood, a daily supplement formulated to support natural lubrication, mood, stress relief and arousal. Within a few weeks, Souza started feeling a change.
For Reed-Smith, relief came in the form of a synthetic peptide known as PT141, also called bremelanotide. It stimulates the central nervous system, targeting the brain’s melanocortin receptors to activate sexual desire and arousal.
The FDA approved bremelanotide in 2019 to treat hypoactive sexual desire disorder in premenopausal women, though it’s sometimes used off-label for men experiencing erectile dysfunction.
After she gave herself the first shot, Reed-Smith’s libido flickered back to life.
“It’s not like [my sex drive] went into overdrive, but I had no problem achieving orgasm. And that happened more than once,” she said. “It was like coming up for air when you’ve been drowning. Like I’m not broken.”
For Rock, the answer was patience. “Once I’d been on the drug for a while, my sex drive did come back, but I wouldn’t say it’s super strong,” she said. “I think my body just kind of got used to the drug and adjusted eventually.”
Doctors say patience may be key.
“The key thing I tell patients is that libido changes, if experienced, are usually not permanent,” said Dr. Fernando Ovalle Jr., a plastic surgeon and obesity medicine specialist. “In many cases, they normalize as dosing stabilizes, side effects improve, nutrition normalizes and the body adjusts.”
“However, if changes are persistent or distressing, they deserve to be taken seriously and managed,” he added.
Eli Lilly, the manufacturer of Mounjaro and Zepbound (tirzepatide), did not respond to The Post’s request for comment.
No regrets
Ovalle said the wide range of experiences with GLP-1s underscores a simple truth: Scientists are still learning about how these drugs affect the body — and the brain.
“We don’t yet have high-quality studies specifically designed to look at libido. So much of what we know right now comes from real-world patient experience rather than formal research data,” he noted.
But for Rock, one thing was clear: “They do work.”
“For years and years and years I lived in a world where it was always ‘someday,’ ‘I’ll do it when…,’ but now that’s today,” she said. “It gave me my life back.”
GLP-1s are generally considered lifelong medications, and many users regain weight after stopping. Souza plans to discontinue tirzepatide once she reaches her goal weight and try to maintain it on her own.
“It kind of numbs you,” she said. “I want to feel normal again.”
Reed-Smith, however, has no plans to quit.
“I would rather be in this body than be sexually active,” she said. “What does that say about me? I don’t know.”
Even so, she hopes other women facing similar challenges don’t turn that frustration inward.
“I want every woman to know that they aren’t broken. It’s because a medication has a side effect, and like any other side effect, it doesn’t affect everyone,” Reed-Smith said. “But if it does, understand that you have not lost something. There are ways you can come back from it.”
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