When you’re getting ready to seek treatment for opioid use disorder (OUD), it’s important to understand how it might affect you. Medications for addiction treatment (otherwise known as MAT) is an effective, science-backed method of managing opioid dependency. But, like any medication, there are some possible side effects to be aware of. Symptoms like nausea, headaches, and dizziness are common topics of discussion, but one side effect that is rarely discussed is changes in sex drive.
Stigmas surrounding addiction can already make it hard to talk openly about treatment and side effects. With the additional taboo topic of sex, some patients might never feel comfortable fully disclosing their symptoms. However, sexual health is just as important to your MAT care team as any other side effects. Recognizing the signs of changing sexual health and speaking about them honestly allows your care team to help you navigate your symptoms.
What is Suboxone?
Suboxone®, a common treatment for OUD, is a combination medication containing buprenorphine and naloxone (important safety information). Buprenorphine is a partial opioid agonist, meaning it activates the opioid receptors, but not as intensely as other opioids. Naloxone is an opioid antagonist that stops the opioid receptors from activating, cutting off the euphoric effects. The combination of the two helps reduce cravings and withdrawal symptoms.
Suboxone and sex drive
Can Suboxone side effects impact you sexually? In short, possibly. Opioid use has long been associated with sexual dysfunction. The Food and Drug Administration warns that long-term opioid use can lead to decreased sex hormone levels and symptoms such as reduced interest in sex, impotence, or infertility. Because buprenorphine is a partial opioid agonist, it can have similar side effects but to a milder extent.
Here are some of the sexual side effects patients may experience on MAT:
- Lower sexual desire or libido
- Difficulties achieving orgasm
- Menstrual cycle irregularities in women
- Erectile dysfunction (ED) and low testosterone levels in men
Sexual side effects in males
In addition to decreased sex drive and problems reaching orgasms, men taking buprenorphine might experience ED and/or lower testosterone levels. One Suboxone side effects study in males showed that 83% of men on buprenorphine experienced some form of sexual dysfunction. The most common side effects were premature ejaculation, ED, and the loss or reduction of sexual desire.
Suboxone side effects in females
Like men, women taking Suboxone may notice lower sexual desire and greater difficulties achieving orgasms. They might also have irregular menstrual cycles. In a Suboxone side effects study on females, about 57% of women on buprenorphine experienced sexual dysfunction. These women most often reported a lack of sexual interest and an inability to feel sexual pleasure or achieve orgasm.
It’s important to note that not much research has been done on the subject. Studies on the sexual side effects of buprenorphine, as well as the differences in how men and women are affected, are generally small and relatively recent. Studies on women, in particular, are scant. More research is needed to determine just how consistent and standard these symptoms are.
Does Suboxone affect fertility?
Opioid use can cause fertility issues in men and women, so it stands to reason that buprenorphine might have similar effects. However, this treatment is considered the gold standard of care for women who are already pregnant and has not been shown to produce adverse outcomes during pregnancy or delivery. Current research also indicates that quitting treatment cold turkey presents greater risks, including withdrawal. While there’s no significant evidence that MAT negatively affects fertility, it’s important to note that more research is needed.
What we do know is that Suboxone can affect the hormones that promote sperm and testosterone production in men, but the presence of buprenorphine is unlikely to increase risks during pregnancy. Sexual dysfunction in general can affect the chances of conception for both men and women. For example, having menstrual irregularities can make it difficult for women to track their cycle. If you are trying or planning to get pregnant, be sure to speak with your MAT care team about your options.
How can I manage my side effects?
Many patients worry about providers dismissing their concerns, but your sexual health is important. These side effects can cause feelings of inadequacy and shame. Sexual dysfunction can affect your sex life, relationships, self-esteem, and quality of life. Some people might stop treatment early to avoid experiencing these symptoms.
However, opioids like heroin, fentanyl, and methadone are known to have far worse effects on sexual health and overall health. Ending treatment could lead to a relapse. For many, the benefits of MAT will outweigh the potential side effects. But that doesn’t mean you need to suffer through your symptoms. When you work with your care team, you can find ways to successfully manage the sexual side effects of Suboxone and get your life back on track.
Navigating side effects with partners
Sexual dysfunction can affect a person’s confidence and ability to form romantic and sexual relationships, but you don’t have to be alone or let your side effects limit you on your treatment journey. When it comes to dating and relationships during MAT, being honest and open is key. Although the conversation can be awkward and uncomfortable, especially in new relationships, having healthy conversations about opioid addictions and treatment can help your partner understand what you’re going through.
Talking to your care team
The first step you should take if you notice side effects is to contact your provider and care team. Many medications and treatment options can help relieve your symptoms. Depending on your symptoms, they may suggest treatments like:
- Hormone therapy to manage testosterone levels
- Oral contraceptives (birth control pills) to regulate menstrual cycles
- Erectile dysfunction medications
- Medications for low sex drive in women
- Psychosexual therapy
- Adjustments to your Suboxone treatment
It is never recommended to stop taking prescribed Suboxone on your own—this can increase your risk of withdrawal or relapse. Make sure to speak with your care team and only take your medication as directed.
Ophelia’s clinicians take a whole-patient approach to care to ensure your treatment protocol makes sense for your life. They’ll make sure your medication dosage is appropriate for your specific needs and provide support at every step.