Abstract
INTRODUCTION: 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. AIMS: The purpose of this report was to present a case study of an obese female patient who received tirzepatide treatment for sexual dysfunction. METHODS: 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. RESULTS: 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. CONCLUSION: 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.