Richard A. Deyo, MD, from the Kaiser Center for Health Research in Portland, OR, and colleagues examined electronic pharmacy and medical records for 11,327 males with back pain seen in a large group model health maintenance organization during 2004. Consideration was given to relevant prescriptions six months before and after the index visit.
The researchers found that males who received medications for erectile dysfunction or testosterone replacement (909) were significantly older than those who did not and had greater comorbidity, depression, smoking, and use of sedative-hypnotics. Long-term use of opioids was associated with greater use of medications for erectile dysfunction or testosterone replacement compared with no opioid use (odds ratio, 1.45). There was an independent association between age, comorbidity, depression, and use of sedative-hypnotics with the use of medications for erectile dysfunction or testosterone replacement. Even after adjusting for duration of opioid use, patients prescribed daily opioid doses of 120mg of morphine-equivalents or more had greater use of medication for erectile dysfunction or testosterone replacement than patients without opioid use (odds ratio, 1.58).
“Dose and duration of opioid use, as well as age, comorbidity, depression, and use of sedative-hypnotics, were associated with evidence of erectile dysfunction,” the authors write. “These findings may be important in the process of decision making for the long-term use of opioids.”