Regular use of opioid prescription painkillers is associated with a higher risk of erectile dysfunction (ED) in men, according to a review of several published studies that examined the sex hormones in people who used opioids on a long-term basis. These studies echo warnings given by the United States Food and Drug Administration (FDA) regarding severe safety issues associated with opioid pain medication and other opioid-related drugs. Opioids Linked to Erectile Dysfunction.
Along with information about impeded renal gland function and central nervous system (CNS) damage, these studies reported that “long-term use of opioids may be associated with decreased sex hormone levels and symptoms such as reduced interest in sex, impotence, or infertility.”
It is important to note is that the FDA has urged caution towards all of these studies, saying that many “had limitations that make it difficult to determine whether the symptoms were caused by opioids or other factors.”
Nonetheless, there have been numerous studies that have pointed towards the continued use of opioids as a potential cause of erectile dysfunction.
What Does the Research Say About Opioids and Erectile Dysfunction?
Sexual dysfunction, in particular ED, is a common problem among people with chronic pain. Numerous studies have identified that prescription opioids can lower testosterone levels, which can cause ED and several other conditions. However, even with this knowledge, there is a relatively small body of medical literature that covers the subject. One reason for this may be that doctors rarely ask about sexual health when compiling a medical history of chronic pain. As a result, determining a link between erectile dysfunction and opioid use can be difficult.
Even still, there are several published studies that the FDA has cited in their warnings towards opioid use, all of which we will take a look at below.
A study published in 2018 in the journal Pain Medicine examined 11,517 patients in Demark who completed a questionnaire about living with cancer. Results from the study found that individuals who used opioids for longer than six months to manage noncancer pain experienced a significant suppression of sexual desire.
Another 2018 study published in the journal Medicina Clinica followed patients with chronic pain over three years. The study found that nearly 27% of patients who used opioids suffered from ED. Those patients also reported having a significant reduction in their sexual desire, as well as increased levels of anxiety and depression.
Looking even further back, a 2013 cross-sectional analysis of pharmacy and medical records found a strong correlation between people who used opioids long-term and those who took medications for erectile dysfunction. The authors of this study identified age, comorbidities such as diabetes or cardiovascular disease, and depression as having possible links to ED.
While these studies have shown a possible link between ED and prolonged opioid use, ending opioid use, especially for those with severe chronic pain, addiction, or other conditions may not be easy simple as stopping. So, how can you treat erectile dysfunction while taking opioids?
Treating Erectile Dysfunction While on Prescription Opioids
For individuals using opioids to treat pain, using testosterone supplements is the most effective therapy. All of the above-mentioned studies cite testosterone supplementation therapy as an effective treatment for erectile dysfunction, with one study stating that nearly 40% of patients showed a significant improvement after being treated with iPDE5 (a common oral testosterone supplement) and/or testosterone gel. However, a more suitable route for many may include erectile dysfunction medications such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra).
Another commonality between the previously mentioned studies is the use of tobacco. Smoking has strong links to erectile dysfunction, and it may contribute to sexual problems during opioid use. One study from 2017 showed a high correlation between tobacco use and those recovering from opioid use disorder. It found that nearly 98% of participants smoked tobacco during addiction treatment for opioids.
Getting help for opioid addiction can be hard, but it doesn’t have to be done alone. Rehabilitation clinics and medical substitutes can help people with opioid dependency. Withdrawal symptoms may be severe, and a medical professional should oversee the process.
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