A number of studies in recent years indicate that men routinely taking powerful pain-killing medications run a higher risk of developing erection problems than those who don’t use these drugs.
Among the most recent evidence developed comes from a Spanish study that offers a theory to explain this link between opioid use and male sexual dysfunction.
The Spanish study was conducted by researchers associated with the University of Alicante and was published in the February 2017 issue of “Medicina Clinica,” a Spanish-language medical journal based in Barcelona. The research team suggests that the association between chronic opioid use and erectile dysfunction stems in large part from the pain-killers’ inhibition of the gonadal-pituitary-hypothalamic axis (a glandular reaction) and a decline in testosterone levels.
Echoes Findings from Earlier Study
The Spanish study largely echoed the findings from a U.S. study published in the May 15, 2013, issue of “Spine.” The American study was led by Richard A. Deyo, M.D., a member of the Department of Family Medicine at Oregon Health and Science University in Portland.
The Deyo-led study focused on the link between the use of ED drugs and testosterone replacement therapy among men being treated with opioids for the relief of chronic back pain. Of the 11,327 men being treated for chronic pain, 909 — just over 8 percent — were also taking ED drugs and/or testosterone replacement therapy.
ED Risk Said to Be Dose-Dependent
American researchers found that the incidence of ED diagnoses among men taking opioid medications for chronic pain was dose-dependent and also linked with the duration of opioid therapy. They also noted that ED was more common among older study participants, as well as those who smoked, suffered from depression, or used sedative-hypnotic drugs.
In the wake of the publication of the Deyo-led study, Andrew Kramer, M.D., a urologist and surgeon at the University of Maryland, was interviewed for an article posted at LiveScience.com. He said he frequently sees a higher incidence of ED among patients who take pain-killing medications.
Such an association is hardly surprising, said Dr. Kramer, because opioid drugs tend to blunt a wide range of bodily functions, including appetite and response to sexual stimuli.
NSAIDs Can Also Cause ED
Although the more recent studies focused on the association between the use of opioid medications and the risk of ED, earlier studies found that heavy use of milder nonsteroidal anti-inflammatory medications, or NSAIDS, could also increase the risk of sexual dysfunction.
One such study into the link between NSAIDs and an increased risk of ED was conducted by researchers associated with the Kaiser Permanente hospital network in California. That study, published in the April 2011 issue of “The Journal of Urology,” looked at the health histories of nearly 81,000 men enrolled in the California Men’s Health Study.
Of the more than 80,000 men studied, 47.4 percent were considered regular NSAID users and 29.3 percent reported that they suffered from moderate to severe ED. Although the incidence of ED was higher among older men and smokers, as might be expected, researchers concluded that regular NSAID use “is associated with erectile dysfunction beyond what would be expected due to age and comorbidity.”
Methadone and ED Risk
Yet another study showing an association between opioid use and a higher risk of ED was previewed online in late 2016 in advance of publication in the “Journal of Addiction Medicine.” The study looked at the incidence of impotence of varying degrees among men on methadone maintenance therapy, or MMT.
Methadone is an opioid drug that is sometimes prescribed for the relief of chronic pain. However, it is more widely used in the treatment of heroin addiction, where it is substituted for the illegal street drug and gradually tapered down in conjunction with psychological counseling and other psychosocial services.
Two-Thirds Suffer from ED
The methadone study, conducted by researchers associated with the University of Malaysia’s Centre for Addiction Sciences, found that 67.4 percent of the men in the MMT program suffered from erectile dysfunction. The severity of their ED symptoms ranged from mild, reported by 26.1 percent of the ED patients, to severe, reported in 17.2 percent of the ED patients.
In line with the findings of earlier studies, the Malaysian researchers also found that the incidence and severity of ED among MMT patients was highest in those who were also diagnosed with depression. MMT study participants who were depressed were more than four times as likely to suffer from ED as those who were not depressed.
Treatment for ED Is Available
Although the treatment of chronic pain with both opioids and NSAIDs has been linked to a higher risk of ED, researchers have also found that many of those diagnosed with ED respond well to the oral ED drugs known as PDE5 inhibitors. These drugs, which include Viagra, Levitra, and Cialis, are available only by prescription in the United States. If you are having erection problems, whether they are linked to the use of pain-killers or not, your doctor can prescribe a PDE5 inhibitor providing there is nothing in your medical history that would make the use of such drugs inadvisable.
Once you have a prescription, you can have it filled at your neighborhood pharmacy or opt instead to order from a reliable online supplier, such as AccessRx.com, which is based in the United States and sells only FDA-approved medications. You will need to fax your prescription or scan and email it along with your order.
If you don’t yet have a prescription, AccessRx can set up an online consultation with a member of its team of licensed U.S. physicians. Based on your symptoms, medical history, and other medications that you may be taking, the AccessRx doctor will authorize a prescription if he or she deems it appropriate. To get started, click below to reach AccessRx’s Erectile Dysfunction page.