Electronic Letters to:

Endocrine Care: Niclaas Bliesener, Susanne Albrecht, Andra Schwager, Klaus Weckbecker, Dirk Lichtermann, and Dietrich Klingmüller Plasma Testosterone and Sexual Function in Men Receiving Buprenorphine Maintenance for Opioid Dependence J Clin Endocrinol Metab 2005; 90: 203-206 [Abstract] [Full text] [PDF]

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Provision of sexual function health care for males on methadone and buprenorphine maintenance

Adam R Winstock, Toby Lea   (6 December 2005)

Provision of sexual function health care for males on methadone and buprenorphine maintenance 6 December 2005
Adam R Winstock, Senior Staff Specialist Drug Health Services, Sydney South West Area Health Service, Toby Lea Send letter to journal: Re: Provision of sexual function health care for males on methadone and buprenorphine maintenance adam.winstock{at}sswahs.nsw.gov.au Adam R Winstock, et al.	Bliesener and colleagues (1) demonstrated that opioid-dependent males maintained on buprenorphine were less likely to experience sexual dysfunction compared with those in methadone maintenance, as evidenced by greater suppression of plasma testosterone and higher frequency of self -reported impairment of libido and potency in methadone maintained males compared with buprenorphine-maintained males and healthy controls. We report findings on a large sample of 308 males currently receiving methadone or buprenorphine for the treatment of opioid dependence in NSW, Australia. As part of a larger study, clients dosed at community pharmacies were asked questions regarding help-seeking behavior on a number of health related issues. With respect to sexual function male clients were asked about impotence, reduced sexual enjoyment and reduced ability to reach orgasm, and whether they had ever discussed it with a doctor or health professional, had ever received help or would currently like help with the sexual health issue. One-third of males in our sample indicated that they had discussed or received help for reduced sexual enjoyment, while one-quarter would currently like help with reduced sexual enjoyment. Twenty-two percent of males had discussed or received help for reduced ability to reach orgasm while 17% would currently like help with this. Seventeen percent had discussed or received help for impotence while 17% would currently like help with this problem. Approximately one-third of those who had discussed or received help for impotence, reduced sexual enjoyment, and reduced ability to reach orgasm would currently like help for these problems. In contrast to the findings of Bliesener and colleagues, our study found no significant difference in self-reported health seeking behaviors between methadone-maintained and buprenorphine-maintained males on any of the sexual dysfunction problems investigated. However, our results support the findings of Bliesener and colleagues in highlighting the high prevalence of sexual dysfunction and unmet health care needs among this group. Treatment providers should consider including assessment of sexual function as a part of routine health care screening in those receiving methadone or buprenorphine for opioid dependence. Reference 1. Bliesener N, Albrecht A, Schwager A, Weckbecker K, Lichtermann D, Klingmuller D. 2005 Plasma testosterone and sexual function in men receiving buprenorphine maintenance for opioid dependence. J Clin Endocrinol Metab 90:203-206