Erectile dysfunction among male heroin addicts receiving methadone maintenance treatment in Guangdong, China

Erectile dysfunction (ED) is common among methadone-maintained patients and reduces their quality of life. This study reports the prevalence of ED among male heroin addicts receiving methadone maintenance treatment (MMT) in China and describes factors that may contribute to ED.

Seventy-four male heroin addicts enrolled in 4 MMT clinics for the first time were interviewed about general baseline characteristics. Scales for assessing erectile function and psychological disorders were completed monthly. Blood was drawn for serum hormone-level measurement at the baseline and at a 3-month follow-up. Daily methadone dosages were recorded by physicians.

Erectile dysfunction was reported in 75.7%, 88.7%, 80.8%, and 80.9% of the patients at the baseline, 1-, 2-, and 3-month follow-ups, respectively. No significant differences in the prevalence of ED were found during the course of treatment. About two-thirds of the patients who had ED at the 3-month follow-up had had the condition while on heroin. The delayed erectile function was significantly associated with duration of treatment (odd ratio, OR1-month vs baseline = 1.86, P = 0.021; OR2-month vs baseline = 1.67, P = 0.066) and methadone dosage (OR = 1.02, P = 0.038). Ongoing substance, serum hormone levels, and psychological disorders were not associated with ED.

The prevalence of ED among male methadone-maintained patients in China is very high and individuals with altered erectile function while on heroin represent a high-risk group for the development of ED upon initiation of MMT. In the setting of delayed erectile function after receiving methadone, a trial of dosage reduction and symptomatic treatments may be a reasonable initial approach.