Painkillers Increase Risk of Erectile Dysfunction

 

Regularly taking prescription painkillers, commonly called opioids, is linked to a greater risk of erectile dysfunction (ED) in men, according to a new study published in Spine.

Over 11,000 men suffering from back pain were involved in the research. The health records of the participants were analyzed to determine whether males taking prescription opioids were more likely to also receive prescriptions for testosterone replacement or ED medications.

The investigators found that over 19% of males who took high-dose opioids for 4 months or more were also given ED prescriptions, while fewer than 7% of males who did not take painkillers received prescriptions for ED.

Over 12% of men who took low-dose opioids for four months or more also received ED prescriptions or testosterone replacement.

Age was the factor most notably linked to receiving ED prescriptions. The men in the study over the age of 60 had a much higher probability of receiving ED prescriptions.

"Men 60 to 69 (years old) were 14 times more likely to receive prescriptions for ED medication than men 18 to 29," the researchers said.

Depression, other health problems (other than back pain), and use of sedative hypnotics, such as benzodiazepines, also raised the probability that men would receive prescriptions for ED.

However, the authors explained, even after adjusting for those factors, men with high-dose opioid use and males with long-term opioid use still had a 50% increased likelihood of recieving ED prescriptions than those who did not take opioids.

Leading author Richard A. Deyo, MD, MPH, investigator with the Kaiser Permanente Center for Health Research and Professor of Evidence-based Family Medicine at Oregon Health & Science University, said:

"Men who take opioid pain medications for an extended period of time have the highest risk of ED. This doesn't mean that these medications cause ED, but the association is something patients and clinicians should be aware of when deciding if opioids should be used to treat back pain."

According to the CDC (Centers for Disease Control and Prevention), the use of prescription painkillers is on the rise in the U.S. The Mortality and Morbidity Report by the CDC revealed that prescription opioid sales experienced a fourfold increase between 1999 and 2010.

A different report, published in the journal Pain, indicated that about 4.3 million Americans use opioid drugs on a regular basis.

The most commonly used prescription opioids include:

• oxycodone
• morphine
• hydrocodone

Deyo said:

"There is no question that for some patients opioid use is appropriate, but there is also increasing evidence that long-term use can lead to addiction, fatal overdoses, sleep apnea, falls in the elderly, reduced hormone production, and now erectile dysfunction."

A CDC report from 2011 found that more Americans die each year from prescription painkiller overdoses than the combined total for cocaine and heroin.

Deyo and his team studied 11,327 men in Oregon and Washington registered for the Kaiser Permanente health plan who saw a doctor for back pain during 2004.

The subjects' pharmacy records for 6 months before and after their doctor's visit for back pain were analyzed to determine whether they had received prescriptions for opioids and for ED or testosterone replacement.

Prescription painkiller use was categorized as:

• none - men who did not receive an opioid prescription
• acute - men who took opioids for 3 months or less
• episodic - men who took opioids for longer than 3 months, but less than 4 months and with fewer than 10 refills
• long-term - men who took opioids for at least four months, or more than 3 months with 10 or more refills

High-dose use was considered anything over 120 mg of morphine equivalent, and low-dose use was considered under 120 mg.

A 2011 study published in the British Journal of Urology International showed that erectile dysfunction is linked to how many different medications are taken.