By Lisa Rapaport

(Reuters Health) – Chronic pain patients who take opioids may be less satisfied with their sex life and more likely to experience a lack of desire than people who don’t rely on these prescription narcotics, a Danish study suggests.

Researchers examined data from questionnaires completed by 11,517 randomly chosen adults in Denmark in 2013. Slightly more than half of the women and slightly less than half of the men said they suffered from chronic pain that wasn’t caused by cancer.

Compared to people who didn’t have chronic pain, individuals who did experience pain but didn’t use opioids were 38 percent more likely to be unhappy with their sex life and 46 percent more likely to report a lack of desire, the study found.

Long-term opioid users were 69 percent more likely than pain-free individuals to report dissatisfaction with their sex life and more than twice as likely to experience low or no desire. Short-term opioid use, meanwhile, was tied to 82 percent higher odds of low desire and 35 percent greater odds of sexual dissatisfaction.

“Patients suffering from chronic non-cancer pain should be aware that it can have a negative impact on their sexual desire and satisfaction with sex life, and that using opioids, especially long-term, can add an additional negative impact on their sex life,” said lead study author Hanne Birke, a researcher at Rigshospitalet, Copenhagen University Hospital.

Other treatments like rehabilitation and behavior therapy may work as well, if not better, for many types of chronic pain without having these sexual side effects, Birke said by email. Unlike just popping a pill, these more active treatments may help patients develop strategies for coping with chronic pain, Birke said.

Amid a worsening epidemic of opioid addiction, doctors often try to prescribe alternative painkillers or other therapies for patients with chronic pain unrelated to cancer. For cancer patients, particularly at the end of life, opioids can provide relief from severe pain and there’s less concern about the long-term risk of addiction.

While opioids have long been linked to sexual problems, the current study offers fresh evidence that the duration of opioid use might influence the magnitude of difficulties with sexual desire and satisfaction, the study team writes in Pain Medicine.

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In the study, pain patients who had used opioids long-term were 81 percent more likely to report lack of sexual desire than individuals who didn’t take opioids for pain.

Just 57 percent of people on long-term opioids for chronic pain reported having sex during the past year, compared with 62 percent of pain patients on short-term opioids, 68 percent of pain patients not taking opioids and 77 percent of pain-free people in the study.

Researchers defined short-term opioid use as having at least one prescription dispensed in the previous year. Long-term users had at least one prescription dispensed in six separate months during the previous year.

Overall, about 19 percent of men and 14 percent of women without chronic pain still reported dissatisfaction with their sex life. And, 7 percent of men and 19 percent of women without pain indicated a lack of sexual desire.

The results add to evidence that both chronic pain and opioid treatment can damage sexual health, said Anne Murphy, a researcher at Georgia State University in Atlanta who wasn’t involved in the study.

“Chronic pain ‘highjacks’ sensory nerve fibers, thereby making it harder or impossible for pleasurable stimuli to elicit a response,” Murphy, who wasn’t involved in the study, said by email. “On top of that, opiates suppress the activation of sensory nerve fibers which would have an obvious impact on sexual pleasure.”

When people do take opioids, they should work with their doctor to make the medication dose as low as possible to reduce pain sensations but still allow them to experience pleasurable sensory stimulation during sex, Murphy advised.

SOURCE: Pain Medicine, online July 2, 2018.