Erection problems are common in adult men. In fact, almost all men experience occasional difficulty getting or maintaining an erection. In many cases, it is a temporary condition that will go away with little or no treatment. However, in other cases, it can be an ongoing problem that can damage a man’s self-esteem and harm his relationship with his partner. Many factors are involved in the problem, and now, a new study has found that men who regularly use strong pain killers are prone to have erectile dysfunction. Researchers affiliated with the Kaiser Permanante Center for Health Research at Oregon Health & Science University (Portland Oregon) published their findings on May 15 in the journal Spine.
The study authors noted that men with chronic pain may experience erectile dysfunction related to depression, smoking, age, or opioid-related hypogonadism (narcotic-related decrease in testicular function). They explained that the prevalence of this problem in back pain populations and the relative importance of several risk factors are unknown. Therefore, they designed a study that examined associations between use of medication for erectile dysfunction or testosterone replacement and use of opioid (narcotic) therapy, patient age, depression, and smoking status.
The researchers examined electronic pharmacy and medical records for males with back pain in a large health maintenance organization (HMO) during 2004. Relevant prescriptions were considered for 6 months before and after the index visit. The investigators found 11,327 males with a diagnosis of back pain. Males who received medications for erectile dysfunction or testosterone replacement (909 men) were significantly older than those who did not and had greater comorbidity (other health problems), depression, smoking, and use of sedative-hypnotics (i.e., tranquilizers, antidepressants, and sleeping pills). The long-term use of opioids was associated with greater use of medications for erectile dysfunction or testosterone replacement compared with no opioid use (1.45-fold increased risk. Age, comorbidity, depression, and use of sedative-hypnotics were also independently associated with the use of medications for erectile dysfunction or testosterone replacement. Patients prescribed daily opioid doses of 120 mg of morphine-equivalents or more had greater use of medication for erectile dysfunction or testosterone replacement than patients without opioid use (1.58-fold increased risk), even with adjustment for the duration of opioid therapy.
The researchers concluded that dose and duration of opioid use, as well as age, comorbidity, depression, and use of sedative-hypnotics, were associated with evidence of erectile dysfunction. They noted that their findings may be important in the process of decision making for the long-term use of opioids. They explained that patients need to be aware that, although these medications may be effective for short-term pain relief, they may not be effective in the long-term for treating chronic pain. Instead of relying on medications, the researchers believe that doctors should encourage alternative treatments for pain relief because there is growing evidence that some of the more effective treatments for persistent pain are rigorously designed exercise programs along with cognitive behavioral therapy.
