Does Suboxone influence your sex drive or ability to get and maintain an erection? Which medication, buprenorphine or methadone has greater sexual side effects?

The long term use of most opiates will have a negative effect on libido, and in some cases, on a man's ability to achieve or maintain a satisfactory erection; and during maintenance treatment with suboxone or methadone, some people will experience sexual side effects that include a loss of desire and a lessened ability to get an erection, or to ejaculate, and in women to achieve an orgasm.

Methadone has been extensively studied, and much is known about the sexual side effects experienced during MM treatment. Long term methadone patients will experience a reduction in basal testosterone levels over time, and ED (erectile dysfunction) or the ability to achieve a satisfactory erection is frequently associated with the use of the replacement opiate therapy. In a recent study in Italy, 42% of men in an opiate substitution program experienced some degree of erectile dysfunction. Obviously, a certain percentage of these men would likely experience ED whether or not they were taking opiate type medications.

Methadone, especially the longer term use of high dosage methadone, is known to induce hypogonadism in some men,

Is Suboxone Better than Methadone?

Buprenorphine (Suboxone) is far less well studied than methadone, but a couple of recent studies have examined the prevalence rates of ED in men taking methadone and buprenorphine.

A 2005 German study examined the influence of methadone and buprenorphine on plasma testosterone levels, and found that methadone had a significant reducing influence on baseline testosterone levels, but buprenorphine did not significantly change these testosterone levels.

A study in 2007 out of Australia indicates that while methadone is likely to induce ED, buprenorphine is not likely to cause an increased rate of erectile difficulty.

The research seems to indicate that for men at least, suboxone creates fewer sexual side effects than methadone.

Anecdotal Reports

Although Suboxone is thought to create fewer sexual side effects that Methadone, anecdotal reports by users of buprenorphine indicate that it is giving some people problems. Although men seem to infrequently complain about an inability to achieve an erection, both men and women complain that the Suboxone can diminish sexual desire (libido) and that it can make it more difficult for men to ejaculate, and for women to achieve orgasm.

Anecdotally, people who suffer these sexual side effects report that they are lessened or removed by dose reductions, and are completely reversible with the cessation of Suboxone use.

Suboxone and Sex

Many people can take Suboxone without any appreciable sexual side effects. A small percentage of users will experience a loss in libido or a loss in the ability to achieve ejaculation/orgasm. Although methadone is known to reduce testosterone levels and induce ED, Suboxone is not thought to do so, or at least, not to the same degree.

Anecdotal reports indicate that Suboxone induced sexual dysfunction is not permanent, and that it is bettered upon dosage reduction, and eliminated upon cessation of Suboxone usage.