Sexual dysfunction in patients with substance use disorders: cross-sectional study and brief literature review
Background: sexual health represents a major part of global health and is directly related to the quality of interpersonal relationships and life. There is a high prevalence of sexual dysfunction in general population but it is even higher when there are comorbid psychiatric disorders and/or addictive disorders such as substance use disorders. The aim of the present study was to study the prevalence of sexual dysfunction in a clinical sample of patients with alcohol and illicit drugs (opioids, cocaine and cannabis) use disorders.
Methods: the present cross-sectional study was conducted in a specialized addictions treatment center from Oporto, Portugal, over a 3-month period in 2023, with a sample size of 41 patients with a diagnosis of at least one substance use disorder. Data were collected using Arizona sexual experiences scale (ASEX) to assess the presence of sexual dysfunction. We conducted a brief literature review using PubMed database to search original and review papers, published in the last 10 years, with the following key-words “sexual dysfunction” and “substance use disorders”.
Results: of the 41 patients that agreed to participate in the study, 27% had a positive result for sexual dysfunction and only 7% had no complaint or difficulty in sexual activity overall. The majority of the patients reported more than one type of sexual dysfunction. Of the 11 patients that tested positive for sexual dysfunction only 3 were abstinent. Relatively to the impact of medication-assisted treatment for opioid addiction, of the 7 patients under methadone treatment, 4 had a positive result for sexual dysfunction and 3 an intermediate one, whereas none of the 8 patients under treatment with buprenorphine had a positive result for sexual dysfunction. Concerning alcohol use disorder, from the 15 patients with alcohol as the primary substance abused, 6 were abstinent and of those 1 had a positive result for sexual dysfunction and 9 were abusing alcohol with 4 of those having a positive result for sexual dysfunction.
Conclusions: substance use disorders increase the chances of having a sexual dysfunction, either as a direct effect of the substance used or of the psychotropics used to treat the addictive disorder and other comorbid psychiatric disorders, or as an indirect result of the social and interpersonal difficulties that arise when there is an addiction. It can be relatively easy to treat and it’s usually not a major concern of clinicians and goes frequently undiagnosed. Recognizing the positive impact of sexual satisfaction in global health is of major importance since addressing and treating sexual dysfunction can improve mood, interpersonal relationships and quality of life and therefore modify the global prognosis of these patients.
