Sexual Dysfunction Improved in Heroin-Dependent Men after Methadone Maintenance Treatment in Tianjin, China

Abstract

ObjectiveTo investigate whether methadone maintenance treatment (MMT) is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT.MethodsThe study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15), and Self-rating Depression Scale.ResultsSexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found.ConclusionsWhile high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study.

Sexual Dysfunction in Men Receiving Methadone Maintenance Treatment: Clinical History and Psychobiological Correlates

“…On one side, the rate of heroin-dependent patients suffering from hypo-sexuality and erectile dysfunction was reported to have significantly increased after methadone maintenance treatment with respect to the prevalence measured before opioid substitution therapy [12,13] . On the other hand, in a more recent study, Zhang et al [14] found a decrease in the severity of sexual dysfunction in association with methadone maintenance initiation. Moreover, in this study, methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction, casting doubts upon a direct negative effect of the opioid agonist medications on the sexual function.…”

Factors associated with perceived loss of libido in people who inject opioids: Results from a community-based survey in France

“…Although a correlation between opioids and sexual dysfunction has been established, no study has yet found any dose-response relationship between testosterone level and opioid consumption (Gerra et al, 2015;Gulliford, 1998;Zhang et al, 2014). The link between buprenorphine -a partial-opioid agonist -and testosterone levels, has not been clearly established, as many results are contradictory (Bliesener et al, 2005;Gulliford, 1998;Hallinan et al, 2009).…”

“…More recent studies have also shown the lower impact of methadone on sexual dysfunction than heroin. In men, sexual dysfunction can even be reduced after methadone treatment initiation (Babakhanian et al, 2012;Zhang et al, 2014), with the exception of premature ejaculation (Chekuri et al, 2012). To date, only four studies on sexual dysfunction have focused on buprenorphine -perhaps because buprenorphine is available in fewer countries than methadone -and only one of these included women.…”

Evaluation of Functional Status Among Patients Undergoing Maintenance Treatments for Opioid use Disorders

“…According, literature reported that opioid patients could experience orgasm dysfunction, a lack of intercourse satisfaction, less sexual desire and a diminished satisfaction after the initiation of methadone treatment [43,44].…”