Men’s Health: Opioids, Alcohol and “Low T”

Substance Use Disorders and Reduced Sexual Functioning:
Studies in opioid pill, heroin addicts and heavy alcohol users, compared to healthy controls, have demonstrated decreased testosterone levels in males resulting in significant sexual dysfunction:man on beach

  • Decreased Libido
  • Erectile Dysfunction
  • Impotence
  • Decreased Testicular Tissue
  • Ejaculation Problems
  • Decreased Sperm Count
  • Decreased Testicular Fluid
  • Decreased  Sperm Motility
  •  Decreased Fertility
  • Enlarged Prostrate
  • Enlarged Breasts

Testosterone Levels in Methadone and Suboxone Treated Patients
In methadone treated male patients, several studies have demonstrated decreased testosterone levels

  • This is a dose-response effect
  • in patients on “low dose” methadone (10-60 mg/day) there was no evidence of lowered testosterone co
  • In “high dose” methadone (80-150 mg/day), there was significant reduction in testosterone

The Impact of Opioids on the Endocrine System:  Massachusetts general Hospital   N. Katz. MD

One study compared:
Endocrine function in 17 men treated with Buprenorphine (Suboxone or Subutex) for addiction, 37 men on high-dose methadone and 51 healthy blood donors served as controls.

  • Patients treated with buprenorphine had significantly higher testosterone levels and a significantly lower frequency of sexual dysfunction compared with patients treated with methadone.
  • The testosterone level of Buprenorphine treated patients did not differ from healthy controls.

Bliesener N et al . Plasma testosterone and sexual function  in men on buprenorphine maintenance for opioid dependence.   J Clinical Endocrinol Metab2005;(1):203-6.
Monitoring Male Patients on Suboxone or Methadone

All male patients treated with Suboxone or Methadone should be closely monitored for sexual dysfunction and as indicated be tested for “Low T”.

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Dr. Michael J. Kittay, M.D.
160 Sylvan Street, Danvers, MA 01923
Phone. (978) 820-5500
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