Opioids and Sexual Dysfunction
A new study found that 53.3% to 81.7% of patients who were opioid dependant (addicted) had problems of sexual dysfunction.1
Two studies from the same team of Spanish researchers offer more evidence: The first study is from the Journal of Sexual Medicine. These researchers suggest:
- Long-term opioid therapy has been found to have a strong impact on the hypothalamic-pituitary-gonadal axis (components of the endocrine system that have an impact on reproductive health and the immune system) , that can be manifested clinically by sexual dysfunction
- This event is rarely reported and thus unnoticed and undertreated. Please see the connection between painkillers and their negative impact on healing: When NSAIDs make pain worse, Getting stem cells ready to heal, Narcotic painkillers increase chronic pain)
- Results of the study:
- Thirty-three percent of 33% of 750 patients with chronic non-cancer pain recorded sexual dysfunction
- Men reported sexual dysfunction significantly more frequently than women (33% vs 25%) although the men reported having a regular partner (84% vs 70%) and a sexually active life (69% vs 34%) significantly more often.
- Sexual dysfunction SD is prevalent in patients with chronic non-cancer pain and higher in men who received a significantly higher mean opioid dose at the same intensity pain level than women.
- Evidence-based interventions to support sexual activity and function in non-cancer pain are needed.2
In second study, published in February 2017 addressed the problems related to men and explored Erectile dysfunction in patients with chronic pain treated with opioids.
In this study the doctors found:
- One of the most relevant side effects of opioid analgesics is erectile dysfunction due in part to the inhibition of the gonadal-pituitary-hypothalamic axis and the decline in testosterone levels.
- Erectile dysfunction was observed in 27.6% of patients on opioids.
- After 6 months, 42% of those patients showed a significant improvement after being treated with iPDE5 – Viagra (48.5%) and/or testosterone gel (81.8%).
- Erectile function and quality of sexual life, as well as anxiety, improved in patients treated chronically with opioids after administering andrological treatment. The management of patients with pain should include a review of their sexual health history given the significant emotional impact posed to the patient, the impact on their overall quality of life and its good clinical response to an interdisciplinary treatment.3
Researchers from Quinnipiac and Yale Universities recently suggested that:
- “long-acting opioid use carries risks of addiction, tolerance, and systemic side effects including hypogonadotropic hypogonadism (impaired hormonal function leading to low testosterone levels).”4
The problem of long-term opioid abuse on men is significant. Harvard researchers found that even after a 14 week trial of supplemental testosterone, symptoms of pain catastrophizing or sleep quality in men was not improved.5
Please see our related article on Hormone replacement therapy and chronic pain.
1 Aggarwal N, Kherada S, Gocher S, Sohu M. A study of assessment of sexual dysfunction in male subjects with opioid dependence. Asian J Psychiatr. 2016 Oct;23:17-23. doi: 0.1016/j.ajp.2016.06.017. Epub 2016 Jul 11. [Pubmed]
2 Ajo R, Segura A, Inda MD, Planelles B, Martínez L, Ferrández G, Sánchez A, César Margarit, Peiró AM. Opioids Increase Sexual Dysfunction in Patients With Non-Cancer Pain. J Sex Med. 2016 Sep;13(9):1377-86. doi: 10.1016/j.jsxm.2016.07.003. [Pubmed]
3 Ajo R, Segura A, Inda MD, Margarit C, Ballester P, Martínez E, Ferrández G, Sánchez-Barbie Á, Peiró AM. Erectile dysfunction in patients with chronic pain treated with opioids. Med Clin (Barc). 2017 Feb 21. pii: S0025-7753(17)30044-1. doi: 10.1016/j.medcli.2016.12.038. [Pubmed]
4. O’Rourke TK Jr, Wosnitzer MS. Opioid-Induced Androgen Deficiency (OPIAD): Diagnosis, Management, and Literature Review. Curr Urol Rep. 2016 Oct;17(10):76. [Pubmed]
5. Huang G, Travison TG, Edwards RR, Basaria S. Effects of Testosterone Replacement on Pain Catastrophizing and Sleep Quality in Men with Opioid-Induced Androgen Deficiency. Pain Med. 2016 Aug 22. [Pubmed]