Erectile Dysfunction Tied to Long-Term Narcotic Use in Men05/15/13
WEDNESDAY, May 15 (HealthDay News) -- If you're a man, the
pain-killing medications known as opioids may do more than relieve
pain -- they may also put a damper on your sex life.
A new study found that men who were prescribed medications for
erectile dysfunction or low testosterone levels were more likely to
be taking opioid (narcotic) medications for chronic back pain.
"People who have persistent pain problems need to know that a potential side effect of long-term opioid use may be erectile dysfunction," said lead study author Dr. Richard Deyo, a clinical investigator for the Kaiser Permanente Center for Health Research in Portland, Ore. "This is not a well-known potential side effect among patients, and it should be considered when thinking about treatment."
Deyo also noted, however, that "the nature of this study as an
observational study limits our ability to make a causal
[cause-and-effect] inference. Opioid use and erectile dysfunction
seem to go together, but we have to be cautious about saying one
causes the other."
Results of the study were published in the May issue of the
More than 4 million people use opioids on a regular basis, Deyo
said. Commonly prescribed opioids include hydrocodone, oxycodone
and morphine. In this study, use of opioids was considered
long-term if patients used them for more than 120 days, or more
than 90 days if more than 10 prescriptions were filled for the
The study included data on about 11,000 men who had back pain.
In that group, more than 900 received medications for erectile
dysfunction or testosterone replacement. Those who were given
prescriptions for erectile dysfunction medications or testosterone
were older than those who didn't get such prescriptions. They also
were more likely to have depression and other health
And those who were taking erectile dysfunction medications or
testosterone tended to be smokers or users of sedative medications,
according to the study.
Erectile dysfunction drug prescriptions were for sildenafil
(Viagra), tadalafil (Cialis) and vardenafil (Levitra).
Age was the most significant factor in getting a prescription
for erectile dysfunction, according to the study. Men between the
ages of 60 and 69 were 14 times more likely to receive a
prescription for an erectile dysfunction medication than men who
were between 18 and 29.
After adjusting the data to account for other possible factors,
including age, the researchers found that men who took opioid pain
medications for long periods were about 50 percent more likely to
take erectile dysfunction medications or testosterone replacement
Dr. Daniel Shoskes, a professor of urology at the Cleveland
Clinic's Glickman Urological and Kidney Institute, said the study
doesn't prove that the pain medications cause the erectile
"A direct association between long-term opioid use and [erectile dysfunction] has not been clearly defined," said Shoskes, who was not involved in the study. "The reason these men were having [erectile dysfunction] could be related to the pain or the things that are causing the pain. You can't conclude from this study that opioid use causes [erectile dysfunction]."
Study author Deyo said there's evidence that men who stop taking
opioids after using them for a short time will see an improvement
in erectile dysfunction, but he said it's not clear if the same is
true after long-term use.
Deyo added that opioids can be effective for short-term use, but
there's "growing evidence that long-term opioid use may not be
effective for chronic pain. The body compensates for taking
long-term pain medications, and changes in the brain and spinal
cord may make people more sensitive over time."
Effective alternatives include a tailored exercise program and
cognitive behavioral therapy designed to help reduce people's fear
of pain, Deyo said.
Shoskes said other factors that contribute to erectile
dysfunction include diabetes, heart disease, peripheral vascular
disease and alcohol use. He said this study may prompt doctors who
treat men with chronic pain to ask about erectile dysfunction,
although he said it's not clear from this study whether the
erectile medications were helpful for these men.
Learn more about erectile dysfunction from the
U.S. National Library of Medicine.
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