Clinical factors associated with sexual dysfunction among men in methadone maintenance treatment and buprenorphine maintenance treatment: a meta-analysis study

Abstract

Methadone maintenance treatment is proven to be effective treatment for opioid dependence. Of the many adverse events reported, sexual dysfunction is one of the most common side effects. However, there may be other clinical factors that are associated with sexual dysfunction among methadone users. We conducted a meta-analysis to examine the clinical factors associated with sexual dysfunction among male patients on methadone and buprenorphine treatments, of which eligible studies were selected using prior defined criteria. A total of 2619 participants from 16 eligible studies, published from inception till December 2012, were identified from the PubMed, OVID and EMBASE databases. The included studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval (CI), 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (odds ratio=4.01, 95% CI, 1.52-10.55, P=0.0049). Our study shows that eight clinical factors are associated with sexual dysfunction among men receiving opioid substitution treatment, namely age, hormone assays, duration of treatment, methadone dose, medical status, psychiatric illness, other current substance use and familial status, and methadone versus buprenorphine treatment. Despite the methodological limitations, the findings of this meta-analysis study may offer better insights to clinicians in dealing with both sexual dysfunction and its related problems.

Sexual Dysfunction in Heroin Dependents: A Comparison between Methadone and Buprenorphine Maintenance Treatment

“…Fourth, sexual hormonal assays such as assays for testosterone, free testosterone, prolactin, luteinizing hormone, and follicle-stimulating hormone were not performed in this study owing to financial restrictions. However, previous studies have already shown that patients on MMT have lower testosterone levels than patients on BMT [ 16 , 46 ], which may explain the higher prevalence of sexual dysfunction in patients on MMT. Fifth, the nature of the study design may have resulted in recall bias, possibly affecting the results.…”

Sexual Dysfunction in Men Receiving Methadone Maintenance Treatment: Clinical History and Psychobiological Correlates

“…Moreover, both psychological and social factors have been associated with sexual dysfunction in patients treated with opioid agonist medications [18] , and more recently, a meta-analysis study demonstrated that the factors associated with sexual dysfunction among men on methadone treatment include age, hormone levels, duration of treatment, methadone dose, medical status, psychiatric illness and familial status, indicating that a complex etiology, and not a single pharmacological cause, may underlie the sexual problems in these patients [19] .…”

Factors associated with perceived loss of libido in people who inject opioids: Results from a community-based survey in France

“…The link between buprenorphine -a partial-opioid agonist -and testosterone levels, has not been clearly established, as many results are contradictory (Bliesener et al, 2005;Gulliford, 1998;Hallinan et al, 2009). However, declarations from participants in various studies would suggest that partial-agonist opioids have less impact on sexual dysfunction than full-agonist opioids like heroin, methadone or morphine sulfate (Al-Gommer et al, 2007;Yee et al, 2014).…”

“…Few studies have examined loss of libido in different populations of people who inject opioids (Yee et al, 2014). The present secondary analysis of the community-based survey PrebupIVinitially conducted to assess the willingness of people who inject drugs (PWID) frequently to receive a novel intravenous buprenorphine treatment (Roux et al, 2017)enabled us to explore libido, which is rarely discussed with health professionals or field workers or indeed in the drug user community.…”