Abstract
Prolonged use of opioids is associated with decreased libido, impotence, delayed ejaculation, vagismus, and anorgasmia. However, data and documentation are lacking regarding the effects of opioids upon sexual dysfunction. No evaluation of sexual dysfunction associated with acute or chronic non-heroin opioid use is published. All evaluations were performed on male heroin addicts or chronic methadone users. Conflicting conclusions were made about the relationship of serum testosterone levels and the incidence of impaired libido, decreased potency, or delayed ejaculation time in heroin addicts or methadone maintained patients. Neuroendocrine events are responsible for sexual dysfunction but it is difficult to discern the exact mechanism involved. From the available data, it is not clear how profoundly opioids influence sexual function. Due to the known variable patient responses to opioids, the studies yield inconsistent findings regarding the patient reportable sexual dysfunctions.