Do opioids affect sexual function in males?

Do opioids affect sexual function in males?
Published : Feb 04, 2024
Last Updated : Feb 07, 2024

According to some research, the long-term use of opioids can lead to the risk of sexual dysfunction in males. However, these studies have limitations and may not take other factors into account that can have a role in leading to sexual dysfunction. So, the role of opioids in sexual dysfunction is not precisely clear. The issues can also result from the interaction of many variables in the person. It can be chronic pain, Depression and Smoking, like other conditions. 

Let's look over the available evidence from the clinical trials about the effects of opioids on sexual health in a person.

Do opioids affect sexual function in males?

The FDA in 2016 warned about serious safety problems with opioid pain medications. They said using opioids for an extended period may lower sex hormone levels. It can lead to symptoms like decreased interest in sex, impotence or infertility. Also, they mentioned that they may also have an impact on your kidneys and the nervous system. 

FDA concluded this based on a published research review in 2016. In this study, the researchers measured the levels of sex hormones in patients who used opioids for an extended period. The authors considered chronic patients who used opioids for the long term. Also, they identified the brand of opioid that already contained warnings of such risks. 

However, The FDA concluded that the studies they reviewed on the top had limitations. It would be hard to tell if opioids caused the symptoms or other factors. Sexual dysfunction is a common problem among people with chronic pain. 

Doctors often don't ask about sexual health when taking a medical history of people with chronic pain. So, it becomes difficult to confirm whether painkillers directly cause sexual dysfunction. 

For example, depression could hide the link between sexual problems and opioids. Depression-like condition is among the risk factors for sexual dysfunction. Some people dealing with it use opioids. Research shows that opioids can worsen or cause depression depression. So, here, the medical community is unsure whether depression depression, opiate use, or both are linked to reduced sexual function. Or whether opiate use worsens both conditions like depression and sexual function. 

Similarly, Smoking is also linked with prescription opioids and having erectile dysfunction(ED). In such cases, it also gets hard to know which factor affects sexual function the most.

What Researches says

Only a few studies are available that investigated how opioid use might affect sexual function. 

In 2018, a study in Denmark asked 11,517 people with cancer to answer a questionnaire. Significantly, the people who took opioids for more than six months to manage the chronic pain were found to be less interested in sex. 

A study conducted in 2017 found that adult men using opioids had an increased risk of having ED. The author added that we need more reliable data and more trials.

Another study in the same year found that many people who recovered from opioid use disorder also smoked. Almost 84 to 98% of participants smoked tobacco during the treatment. And generally, Smoking has a link to sexual disorders like Erectile dysfunction. It may lead to sexual dysfunction during opioid use. 

 A study in 2013 found a strong link between long-term opioid use and taking ED medications. The authors also found their age, comorbid medical conditions and depression depression to identify a link with ED. The results show it's difficult to separate opioid use as a cause of sexual dysfunction. 

 A study published in Spine Journal in 2013 found that men who used opioids for a long time were more likely to use treatments for ED. Also, they took hormone replacement therapies. This study involved 11,327 adult male participants who were diagnosed with back pain. The researchers also noted that 909 took medications for ED or testosterone replacement. These participants were significantly older than those who did not take treatment for sexual problems. Also, they smoke, have depression depression and use sedative-hypnotic drugs.

 The researchers found that about 20% of people who took a lot of opioids for an extended period had sexual dysfunction.

Effects of opioids on hormones

The use of opioids can influence hormones in the hypothalamic-pituitary-gonadal pathways. These pathways regulate sex hormone production by secreting gonadotropin-releasing hormone (GnRH). When opioid inhibits GnRH, it may decrease the production of luteinizing hormone in the body. As a result, it will inhibit the production of sexual hormones like testosterone.

Having Low testosterone can cause depression and sexual issues in men and women. It is the reason that their overuse of opioids may impair sexual function. 

Opioids and female sexual function 

There has been little research to investigate a potential link between female sexual dysfunction and opioid use. 

However, a study in the Journal of Clinical Endocrinology and Metabolism found that female participants who received opioid treatment via the spine had decreased libido. The same treatment in the Male participants showed decreased libido or impotence.

Also, one study from 2016 showed that female partners of males dependent on opioids may experience altered sexual function. They had altered desires and attitudes towards sexual contact. 


One way to treat sexual problems in men taking opioids for pain is through testosterone supplements. Also, a doctor may recommend using ED medications to improve male sexual function. These drugs include Sildenafil(Viagra), Tadalafil (Cialis), or Vardenafil(Levitra), which are available under prescription. 

Some people who deal with opioid dependency may seek help through rehabilitation clinics. In some cases, the withdrawal symptoms can be severe, so the process must go under the supervision of a medical professional.

However, doctors are less sure about treating opioid-related sexual dysfunction in females. It is because of the lack of research. However, the only options in the field include androgen treatment and hormone therapy.

Some FaQs

Can opioids cause permanent ED?

Yes, opioids may lead to erectile dysfunction, and it may be referred to as Norco erectile dysfunction or opioid-induced ED. Sexual dysfunction like ED can be a possible side effect of opioid medications. People who overuse or misuse and do not take them as prescribed will likely face such side effects. 


What drugs cause sexual dysfunction?

Certain medications may contribute to sexual dysfunction; these drugs include-

  • Some Antidepressants
  • Blood pressure medications
  • Cancer treatments
  • Antiepileptics
  • Opioids
  • Medications that affect sex hormones
  • Antipsychotics drugs
  • Statins
  • Histamine-2 antagonists(H2 blockers)
  • Heart failure medications
  • Benzodiazepines


Can drug-induced erectile dysfunction be reversed?

Tweaking the drug's side effects may help in reversing ED-like medical issues. A testosterone supplement is one of the primary ways to treat Ed in such cases. Consult a doctor to get the most appropriate treatment to treat drug-included ED.