Erectile dysfunction
Narcotic painkillers may contribute to sexual problems in men

THE QUESTION Men being treated for chronic pain frequently experience sexual dysfunction. Might a contributing factor be the powerful drugs often prescribed to quell their pain?

THIS STUDY analyzed data on 11,327 men (average age, 49) with chronic back pain. More than half of them were taking an opioid painkiller, and 909 were taking a medication for erectile dysfunction or low testosterone. The longer men had taken opioids, and the higher the dose, the more likely they were to have evidence of sexual dysfunction. Among those taking high-dose opioids (equivalent to 120 milligrams of morphine) for more than four months, more than 19 percent were taking erectile dysfunction or testosterone replacement medication, compared with 12 percent of men taking lower-dose opioids for that length of time and 7 percent of those taking no opioids. Older men were far more likely to have a prescription for erectile dysfunction or low testosterone, but after adjusting the data to accommodate age, men taking high-dose opioids were still 50 percent more likely to also be taking an erectile dysfunction drug or testosterone replacement therapy than were men not taking the narcotic painkillers.

WHO MAY BE AFFECTED? Men taking a narcotics prescription for chronic back pain. Though effective at easing pain, opioids cause drowsiness, can be addictive and are among the most frequently abused prescription drugs. They include such drugs as codeine, Oxycontin (oxycodone), Vicodin (hydrocodone with acetaminophen) and Demerol (meperidine).

CAVEATS Data on sexual dysfunction came from prescription records rather than diagnoses. The study did not identify specific opioids taken by the men. The results indicate a likely link between opioid use and sexual dysfunction but do not prove cause and effect.

FIND THIS STUDY May 15 issue of Spine.

LEARN MORE ABOUT erectile dysfunction at

Learn about opioids at (search for “safe use of pain medicine”).

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.