Opioids and sexual health: A narrative review

Abstract

Opioid dependence is the commonest drug dependenceafter cannabis worldwide. Physiologically, opioids, by theiracute effects, cause enhanced sexual performance whileused chronically; they cause sexual dysfunction primarily byinfluencing the hypothalamo-pituitary-adreno-gonadalaxis. Men with opioid use had a significantly increased riskof erectile dysfunction with a relative risk of 1.96. Decreasein sexual desire/libido, anorgasmia, premature ejaculation,loss of ability to attain an erection, decreased sexualsatisfaction after intercourse, amenorrhoea, anovulationare the critical effects of long-term opioid usage on sexualhealth. Such effects are also prominent in those on opioidsubstitution therapy with buprenorphine and methadone.Hence sexual assessment should be an essential part of theevaluation of those on long-term opioids. Also, the sexualdysfunction due to long-term opioid usage should beadequately addressed.