Sex and Pain Meds
By this point, I am sure you have heard the numerous warnings about how the long term use of certain pain medications can affect your body. Opioid medications, commonly called ‘narcotic’ pain medications, have been under the microscope over the past few years. This is for good reason. The explosion in the use of opioid pain medications has enabled us to learn a lot more about these medications than was originally thought. Initially, these medications were designed to be used only for short term purposes (such as following surgery) or for terminally ill cancer patients. For various reasons, the use of prescription opioids has grown over the past few decades and a lot of patients are now using these medications on a daily basis.
The potential side effects of long term opioid use are numerous. Some are well known, such as dependence, addiction, constipation, and sedation. But we now know that these medications can affect your body in other ways. Chronic opioid use has been shown to permanently affect learning and the formation of new memories. They have also been shown to actually worsen the perception of pain (there will be more on this in a future blog).
So what does this have to do with sex? After all, that’s the only reason why I am reading this anyways.
Ok, gotcha. So in addition to the above mentioned side effects it has also been found that the chronic use of opioid medications leads to alterations in numerous hormones in the body, some of which are the sex hormones. While an in depth explanation and discussion of the endocrine system is beyond the scope of this blog, I will explain the basics. When opioid medications bind to the parts of the brain called the hypothalamus and pituitary, they prevent the release of sex hormones; namely testosterone, estradiol, leutinizing hormone, and follicle-stimulating hormone. In women, this can cause menstrual irregularities. In men, this can cause erectile dysfunction, loss of muscle mass, and decreased sperm count. In both sexes, the decreased hormones can result in decreased libido, fatigue, generalized weakness, osteoporosis, depression, anxiety, and anemia (amongst other things).
This is not to say that you absolutely have to stop taking your pain medications, as it is not easy to have sex when you are in a lot of pain. But, it does hopefully open your eyes to the potential side effects of these medications and make you think about talking with your doctor about possibly trying to taper down these medications to as low a dose as possible.
- Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, Dana T, Bougatsos C, Deyo RA. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015 Feb 17;162(4):276-86. PubMed PMID: 25581257