Can Painkillers Keep Men Down?

Erectile dysfunction more likely in men with long term opioid usage and other factors

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Opioid painkillers can provide much-needed relief from many painful conditions. But long term use of these medications can increase the chances of having erectile dysfunction in some men.

The use of opioid painkillers and sedative hypnotics, which are medications often used to treat anxiety, was linked with a higher risk for erectile dysfunction, a new study found. Depression, related illnesses and age also also affected this risk.

The researchers said that use of opioids and how it impacts erectile dysfunction should be taken into consideration when deciding how long to use the pain medicine.

"Talk to your pharmacist about side effects of opioid pain relievers."

Opioids diminish pain signals heading to the brain, which reduces the feeling of pain. Opioids include hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) and morphine (Kadian, Avinza).

Richard Deyo, MD, MPH, from the Departments of Family Medicine, Medicine, Public Health and Preventive Medicine at the Center for Research on Occupational and Environmental Toxicology, and colleagues investigated the links between medication use for erectile dysfunction or testosterone replacement and use of opioid therapy.

The researchers also looked at the links between erectile dysfunction medication use and patients' age, depression and smoking status.

According to this study's authors, previous research has shown that men with chronic pain might have erectile dysfunction due to smoking, age, depression or trouble creating enough sex hormone because of opioid use.

This study included 11,327 men who were diagnosed with back pain. Within that group, 909 received medication for erectile dysfunction or testosterone replacement.

The researchers looked at patients' electronic medical records and pharmacy records in 2004 and noted relevant prescription medications taken six months before and after the start of the study.

Men who received medicine for erectile dysfunction or testosterone replacement were significantly older than those who did not receive the medicines, the researchers found.

The men who received the medications also had more illnesses related to erectile dysfunction. They were also more depressed, smoked more often and used sedative hypnotics more frequently.

The researchers also found that men who used opioids over the long term or who were prescribed at least 120 milligrams of daily opioid medications were roughly 45 and 58 percent more likely, respectively, to use erectile dysfunction or testosterone replacement medications.

In addition, age, depression, related illnesses and sedative-hypnotic use were independently linked with use of erectile dysfunction medication.

Identifying and treating sexual dysfunction and low levels of sex hormone production might reduce pain and depression in long-term opioid users, which the researchers said in turn could minimize how much of the pain medicine is taken.

"For clinicians, our data provide a reminder that information on sexual dysfunction should be part of clinical decision making with regard to long-term pain management and provide some evidence regarding its prevalence," the researchers wrote in their report. "Both patients and clinicians should recognize possible opioid effects on sexual functioning in considering treatment options."

Future research should look more into sexual dysfunction in patients with chronic pain, the researchers said.

The researchers noted that they did not determine why opioids were prescribed to men in the first place, and patients could have had multiple pain conditions.

In addition, the researchers did not find out why certain patients were likelier to take erectile dysfunction medicines since the condition could have started before patients had back pain.

The study, supported by grants from the National Institute of Health and the National Center for Research Resources, was published online May 15 in the journal Spine.

Reviewed by: 
Review Date: 
May 15, 2013
Last Updated:
September 17, 2013