Opioid painkillers, which are often prescribed to treat chronic pain associated with arthritis and related conditions, can cause sexual dysfunction. Ironically, sexual problems often accompany chronic pain conditions - for obvious reasons - and opioid painkillers can just compound the problem. Unfortunately, patients and doctors rarely confront the issue.

There is evidence that suggests long-acting opioids can reduce hormonal function in men and women, if taken daily for longer than a month. There also can be other problems associated with opioid use including weight gain, fatigue, depression, osteoporosis, and irregular menstrual cycles. The problems are treatable if properly diagnosed, according to Stephen Colameco, MD, in a April 2008 commentary on pain-topics.org. Dr. Colameco also points out:

• different approaches for men and women are needed in treating the complications of opioid use
• testosterone supplementation can be effective for men (topical, buccal, transdermal preparations are preferable to intramuscular injections)
• DHEA/DHEAS supplementation is preferable for women
• doctors should inform patients that hormonal disturbances can occur with high-dose, longterm opioid treatment
• lab tests should be ordered if hormonal deficiency is suspected
• rotating from one opioid to another may be helpful

Better understanding of the side effects associated with opioids and better communication between doctors and patients is needed. While the problems connected to opioid use are very real for some patients, there may not be reason to just live with it.

Related Resources:

• The Facts of Painkillers
• Guide to Sexuality and Arthritis
• How Arthritis Complicates Sexuality
• Do Arthritis Patients Vary in Pain Tolerance?
• When Are Pain Medications Appropriate for Arthritis?

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