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Abstract

Introduction: We intended to assess the prevalence of sexual dysfunction in men receiving opioid substitution therapy in a Portuguese center, which domains of sexual function are affected, and which factors influence sexual dysfunction.
Methods: We conducted a self-administered form, including: sociodemographic and clinical characterization; maintenance treatment with methadone or buprenorphine; presence of anxiety/depression, assessed with Hos-pital Anxiety and Depression Scale; sexual dysfunction, assessed with Massachusetts General Hospital – Sexual Functioning Questionnaire; erectile dysfunction, assessed with International Index of Erectile Function.
Results: A total of eighty-two patients participated in the study. Of these, 80.5% were receiving methadone treat-ment, with a mean current dose of 53.5 mg, a mean duration of treatment of 12.6 years, and a mean maximum dose of 86.2 mg. Buprenorphine was used by 19.5% of participants, with a mean current dose of 5.74 mg, a mean duration of treatment of 10.4 years, and a mean maximum dose of 8.07 mg. Antidepressants and antipsychotics were taken by 23.8% and 14.8% of participants, respectively. Anxiety and depression were present in 43.5% and 46.2% of cases, respectively. The Massachusetts General Hospital – Sexual Functioning Questionnaire revealed that 42.1% had sexual dysfunction and the item with the lowest score was general satisfaction. The International Index of Erectile Function revealed that 67.9% had erectile dysfunction and the item with the lowest score was achieving and maintaining an erection. There were no statistically significant differences between patients treated with methadone or buprenorphine, regarding the presence of sexual dysfunction and erectile dysfunction. The factors significantly correlated with sexual dysfunction were: age, professional status, maximum methadone dose used by the patient, anxiety, and depression. The factors significantly correlated with erectile dysfunction, e não; maximum methadone dose used by the patient, tobacco, anxiety and depression.
Conclusion: We did not find evidence to switch from methadone to buprenorphine, if sexual dysfunction arises. Anxiety and depression seem to be the factors most correlated with sexual dysfunction and erectile dysfunction.