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Opioids and Libido

Opioid drug use can cause sexual dysfunction and lead to a reduced sex drive or lowered libido. The longer opioids are used, the more pronounced the issues can be.

Stopping opioid use generally can reverse sexual problems.

Decreased Libido With Regular Opioid Use

Opioids are some of the most widely used and abused drugs in the United States. Opioids are prescribed for pain relief, and because of their intensely addictive nature, they are often misused.

In 2016, the U.S. Food and Drug Administration (FDA) issued a warning pertaining to opioid use and the potential for sexual dysfunction. Long-term opioid drug use can be habit-forming and lead to decreased production of sex hormones. These can lead to impotence, infertility, and a reduced interest in sex, or a lowered libido.

Libido is defined as sexual desire. It can be influenced by drugs, such as prescription painkillers like OxyContin (oxycodone), methadone, and Vicodin (hydrocodone/acetaminophen) and illicit opioids like heroin and fentanyl.

Opioids interact not only with the reward processing and pleasure center in the brain, as well as the endocrine system, which can affect sex drive. Typically, impacts on the libido caused by opioid use are considered to be reversible if use is stopped.

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Opioids and Sexual Dysfunction

Chronic pain is an issue that affects about 100 million Americans, and opioids are often prescribed to mitigate symptoms and improve quality of life. Opioids interact with brain chemistry to block pain sensations, increase pleasure, and act as central nervous system depressants.

They also can influence sex hormones, libido, and sexual functions, especially when used long-term. Individuals who have chronic pain and take opioid drugs, as a result, are more likely to struggle with a lack of sexual desire and more sexual-related issues, Physicians Weekly reports. Both chronic pain and opioid use can lead to sexual dissatisfaction.

Opioids are also commonly abused, and opioid misuse can create further issues with sexual satisfaction and libido. Studies show that between 34 and 85 percent of individuals battling heroin addiction have some level of sexual dysfunction.

Common side effects of opioid use on sexual function include:

  • Lowered levels of sex hormone production
  • Decreased interest in sex
  • Infertility
  • Impotence
  • Erectile dysfunction
  • Disrupted menstrual cycle
  • Premature ejaculation

Chronic and long-term opioid use can also lead to mental health issues, including depression, sleep problems, and anxiety. These can also have negative influences on sex drive and libido.

Specific Impact of Opioids on Hormone Levels 

Opioids interact with the endocrine system, which leads to a suppression of the gonadotropin-releasing hormone by decreasing its hypothalamic secretion. This creates hypogonadism, which reduces hormone secretion by the gonads — testes for men and ovaries for women.

As a result, this causes lower levels of testosterone being produced by the gonads, which in turn leads to a depressed sex drive and lowered levels of sexual desire.

Opioid dependence can lead to disruptions in menstrual cycles in women and erectile dysfunction in men, the journal Practical Pain Management explains. Opioid use can also influence adrenal androgen production, which can impact hormone levels that are precursors to testosterone. Lower levels of testosterone can have a negative impact on sexual desire and libido levels.

Impact on Sex Drive

The longer you use an opioid drug, the more detrimental effects the drug will have on the brain and body. Hypogonadism can occur with relatively short-term opioid use, but the journal Pharmacy Times publishes that it is typically reversible.

The longer that opioid drugs are used, and the more that is used with each dose, the more pronounced all issues will be, including the impact on sex drive. Stopping opioid use may be able to reverse the negative influence of these drugs on libido, however. 

It can take time for the brain and body to heal from long-term opioid use in the presence of dependence and/or addiction.

Opioid withdrawal symptoms, such as insomnia, depression, anxiety, and flu-like physical symptoms, can impact sexual desire and function as well.

They can last for several days to weeks after stopping an opioid drug.

Typically, a medical detox program is ideal when opioid dependence is present, and opioid drugs have been used repeatedly for weeks, months, or longer.

Opioid addiction is best treated through a complete addiction treatment program.

Such a program can manage the physical, emotional, social, and behavioral aspects of the brain disease while offering support to lower the risk of relapse.

Opioids should not be stopped cold turkey after regular use even if they are affecting your sex drive. Talk to a doctor about opioid use and sexual functions before stopping these drugs. 


(March 2016) FDA Drug Safety Communication: FDA Warns About Several Safety Issues With Opioid Pain Medicines; Requires Label Changes. U.S. Food and Drug Administration (FDA). Retrieved April 2019 from

(January 2016) SCOPE of Pain: An Evaluation of an Opioid Risk Evaluation and Risk Mitigation Strategy Continuing Education Program. PAIN Medicine. Retrieved April 2019 from

(July 2018) Opioids Tied to Bad Sex Life and Lack of Desire. Physicians Weekly. Retrieved April 2019 from

(October-December 2014) Sexual Dysfunction in Patients with Alcohol and Opioid Dependence. Indian Journal of Psychological Medicine. Retrieved April 2019 from

(January 2019) Sexual Dysfunction and Long-Term Opioid Use. Medical News Today. Retrieved April 2019 from

(February 2009) The Impact of Opioids on the Endocrine System. The Clinical Journal of Pain. Retrieved April 2019 from

(December 2011) Opioid-Induced Sexual Dysfunction. Practical Pain Management. Retrieved April 2019 from

(September 2015) Opioid- Induced Androgen Deficiency: Pharmacist Counseling Points. Pharmacy Times. Retrieved April 2019 from




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