Opioid-Induced Sexual Dysfunction: Causes, Diagnosis, & Treatment

Sexual dysfunction is a common problem among patients with chronic pain. Yet, many of these patients suffer in silence, healthcare providers rarely ask about patients’ sexual concerns, and guidance literature on the subject is relatively scarce. Ironically, in many of these cases the long-acting opioid medications prescribed to relieve patients’ pains may be causing or contributing to their sexual problems. Since the 1990s, prescriptions written for opioid medications have significantly and steadily increased [Olsen et al. 2006]. Along with that, there have been increasing concerns about adverse consequences of opioid treatment, and opioid-induced endocrine deficiency leading to sexual dysfunction is one the most common yet most frequently undiagnosed problems with opioids. Considerable evidence through the years has suggested that longacting opioids used on a daily basis for more than a month can have a number of adverse effects on human endocrine function. The most common and clinically significant effects are androgen deficiencies and menstrual cycle abnormalities [Abs et al. 2000; Adams et al. 1993; Allolio et al.