Could methadone be causing my sexual problems?

Some surveys have found that as many as 9 out of 10 men and women entering MMT programs have sexual difficulties of one sort or another. But such problems are not caused directly by methadone, and, in almost all cases, these persons can be helped to experience intimate relationships with a partner and enjoy sex.

There are many causes of possible sexual and reproductive problems in MMT patients. Past use of illicit drugs and alcohol could have upset hormonal balance in the body, which often returns to normal over time. Some prescribed medications, such as certain antidepressants, may cause impotence (trouble getting an erection) or lack of orgasm as a side effect. Then, there are many psychological issues that could have left sexual problems in their wake, such as previous sexual abuse or long-lasting anxiety and guilt from a drug-addicted lifestyle.

Males engaged in MMT have been reported to have higher levels of sexual dysfunction than the general population. However, the prevalent types of and potential causes for sexual dysfunction in this population are still unclear. One study of MMT patients found that erectile and sex-drive (libido) dysfunction that increased with increasing age of the patient, as might be expected. Duration of methadone treatment was not associated with increasing levels of dysfunction. Depression was significantly associated with increased erectile and orgasm dysfunction. In general, the prevalence of sexual dysfunction in this MMT population appeared similar to that which occurs in the general population.

Another research study, in women, noted that menstrual disruptions caused by past heroin abuse were very common in these patients. However, with increasing tenure in MMT, menstrual cycle irregularities improved in most of the women; some resumed menstruating again for the first time in years.

There are many ways that MMT clinic staff can help patients to overcome sexual or reproductive problems – such as, prescribing special medications, changing existing medications, or providing specialized counseling. Unfortunately, when it comes to sexual matters, many patients are embarrassed to mention their concerns and suffer in silence. It is important to overcome this discomfort or shyness and ask for the help that is available.

Also: Brown R, Mundt M, Plahn S. Methadone maintenance and male sexual dysfunction. ASAM Conference; Washington, DC; April 22-25, 2004. Abstract 3A.

Schmittner J, et al. Menstrual function during methadone maintenance. Paper presented at: CPDD (College on Problems of Drug Dependence) 65 th Annual Meeting; June 2004; San Juan, Puerto Rico.