Sexual Dysfunction Improved in Heroin-Dependent Men after Methadone Maintenance Treatment in Tianjin, China

Minying Zhang,Keming Rou,Mianzhi Zhang,Huifang Zhang,Zunyou Wu,Baohua Zhang,Linglong Zhao,Cynthia X Shi,Jennifer M Mcgoogan,Alice Y W Chang

doi:10.1371/journal.pone.0088289

Minying Zhang, Keming Rou + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0088289

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Journal: PLoS ONE	Publication Date: Feb 10, 2014
Citations: 56	License type: CC BY 4.0

Affiliation: Nankai University, Ankang City Central Hospital

Abstract

ObjectiveTo investigate whether methadone maintenance treatment (MMT) is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT.MethodsThe study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15), and Self-rating Depression Scale.ResultsSexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found.ConclusionsWhile high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study.

Highlights

The association between sexual dysfunction and use of opioids has been described extensively [1,2,3]
Using methadone maintenance treatment (MMT) to treat opioid dependence began in the United States in 1964, and it has been shown to be an effective intervention in controlling drug use among heroin addicts [5,6]
23 men declined to participate and a further 52 men were excluded because they reported purposely reduced the frequency of sexual intercourse for reasons other than sexual dysfunction

Summary

Introduction

The association between sexual dysfunction and use of opioids has been described extensively [1,2,3]. Previous studies found that sexual desire was enhanced among drug users during the initial six months after starting drug use. Heroin users reported gradually decreasing and disappearing sexual interest. Palha and Esteves found that 72% of men and 65% of women who used heroin for more than six months reported decreasing satisfaction with their sexual behavior [4]. Using methadone maintenance treatment (MMT) to treat opioid dependence began in the United States in 1964, and it has been shown to be an effective intervention in controlling drug use among heroin addicts [5,6]. Positive effects of methadone maintenance include reduced frequency of opioid use[7], reduced frequency of criminal behavior [8], reduced HIV transmission [9], mortality reduction [10], and improved employment status [11]

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