Sexual dysfunction is a problem that can manifest in a number of ways, including decreased desire for sex, pain during sex, and erectile dysfunction.
Taking naltrexone for opioid dependence or alcohol use disorder may have sexual side effects, in part due to the effects of this medication on the body’s endogenous opioid system and hormones.
The side effects of naltrexone on sexual function can vary, depending on a person’s history of substance use, recent drug or alcohol use, and other personal factors.
What Causes Sexual Side Effects While Taking Naltrexone?
Naltrexone belongs to a group of medications known as opioid antagonists. It binds and blocks opioid receptors in the body, which can in turn affect hormone regulation.
Opioid drugs are known to lower free and available testosterone. While naltrexone isn’t an opioid, its antagonistic effects on opioid receptors can produce a hormone response.
Hormonal regulation plays a central role in the function of sexual organs, sexual desire, and menstruation. Changes to hormone levels, therefore, may disrupt this.
Does Naltrexone Cause Erectile Dysfunction?
Erectile dysfunction, or impotence, is a side effect that can occur while taking naltrexone, also known as Vivitrol or Revia.
Risk factors for this might include:
- older age
- chronic opioid dependence
- high stress
Chronic opioid dependence can lead to effects on sexual function. In healthy adults without a history of opioid abuse, naltrexone may help treat erectile dysfunction.
However, while naltrexone—an opioid antagonist—can block euphoric effects of opiates, its use may not necessarily reverse or treat sexual side effects caused by opioid dependence.
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Does Naltrexone Cause Premature Ejaculation?
Premature ejaculation is a common symptom associated with naltrexone use, in addition to erectile dysfunction and general physical weakness.
Does Naltrexone Affect The Menstrual Cycle?
Naltrexone has been studied for its potential to treat weight loss-related amenorrhea, or the absence of one’s monthly menstrual periods.
Irregular menstruation is a hormonal issue that can occur as a result of chronic alcohol abuse, opioid abuse, stress, malnutrition, or health conditions such as endometriosis.
Naltrexone is not known to cause irregular menstruation. If this does occur, consider contacting your doctor to discuss potential causes.
Can Natrexone Affect Sex Drive?
Reduced desire for sex is a common side effect of all medications for opioid use disorder, including naltrexone, methadone, and buprenorphine (Suboxone).
During naltrexone treatment, people taking this medication may experience less interest in having sex or feel less satisfied after engaging in sexual activity.
Risk Factors For Sexual Side Effects Of Naltrexone
Sexual dysfunction can be influenced by a whole host of factors unrelated to the use of naltrexone.
Additional risk factors for sexual dysfunction may include:
- high stress levels
- certain medical conditions (e.g. diabetes)
- kidney or liver failure
- concern about sexual performance
- past sexual trauma
- relationship problems
- use of antidepressants (e.g. SSRIs)
Treatment for sexual dysfunction may come in the form of hormone replacement, or the use of behavioral treatments such as cognitive behavioral therapy or relationship counseling.
Although it can be difficult to talk about sexual side effects from medication use, discussing this with a doctor may offer an opportunity to find a treatment best suited for you or a loved one.
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- Fertility Appreciation Collaborative to Teach the Sciences (FACTS) — Naltrexone in Weight-Loss Related Amenorrhea: A Review of Research
- Filter Magazine — The Tricky Connection Between MAT and Low Sex Drive
- U.S. National Library of Medicine: PubMed — Sexual Dysfunction in Patients with Alcohol and Opioid Dependence
- U.S. National Library of Medicine: PubMed — Sexual Dysfunction among Male Patients Receiving Buprenorphine and Naltrexone Maintenance Therapy for Opioid Dependence
- U.S. National Library of Medicine: PubMed — Sex differences in acute hormonal and subjective responses to naltrexone: The impact of menstrual cycle phase