Suboxone is a common prescription medication for opioid use disorder (opioid addiction). It reduces cravings, stabilizes recovery, and helps make withdrawal symptoms to be more easily managed. Suboxone can be a life-saving medication when assisting someone in gaining control over their opioid use disorder, but like any medication, there can be side effects. Some of the more commonly known side effects of Suboxone include nausea, headaches, constipation, and insomnia. For most people, these side effects are minimal and don’t outweigh the way the medication helps people gain control and a sense of normalcy in their lives.
The unspoken sexual side effects of MAT
There are some lesser-known side effects of Suboxone that many folks find embarrassing and hard to talk about. It is estimated that about 20% of people taking Suboxone or buprenorphine may experience some type of sexual impact. This may be a lower rate than experienced by those using methadone for MAT, but is still significant. It has been suggested that these effects occur because opioids and opioid agonists such as Suboxone can affect the body’s hypothalamic-pituitary-gonadal axis, which is responsible for producing the hormones associated with sex and reproductive matters. Some of the reported adverse sexual dysfunctions (most of which are potential side effects of all opioid use) include:
- erectile dysfunction
- reduced satisfaction during sex
- orgasmic dysfunction
- low libido (low sexual desire)
- low testosterone
- changes in menstruation
- premature ejaculation/ejaculatory dysfunction
Of these side effects, the most commonly occurring ones have been reported to be erectile dysfunction and decreased libido. Both men and women report that Suboxone can diminish sexual desire, making it more difficult to orgasm.
For many, sexual function really matters
From the outside, the risk of sexual side effects might sound like a small price to pay to recover from opioid use disorder. But affected sexual function can have repercussions for an individual’s relationships, sense of satisfaction with life, and self-esteem, and can create barriers to long-term recovery. Sexual dysfunction can make people feel defective or broken. Some people feel ashamed and want to stop treatment early in an attempt to rectify the situation. It’s important to remember, though, that opioid use on its own causes sexual dysfunction. So if quitting treatment leads to a relapse or if there has been long-term opioid use, sexual function may not improve.
Talk to your provider about treatment options
While the side effects listed above can be concerning, there is good news. If you experience them, you are not alone and they are treatable!
There are many treatment options for sexual dysfunction available while taking Suboxone. If you experience any form of sexual dysfunction or side effects while taking Suboxone, talk with your clinician. They can tell you about treatment options, which may include medications to alleviate some of the side effects. Some possible treatments include:
- hormone therapy to mitigate low testosterone
- adjusting your Suboxone dose—NOTE: This should only be done under your clinician’s supervision!
- erectile dysfunction medications like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
- medications for female libido like flibanserin (Addyi)
- oral contraception pills
- psychosexual therapy—because human sexuality is complex and heavily influenced by our mental and emotional states
There have been cases of drug interaction effects between Suboxone and some of these medications, so be sure to talk through what to expect and how to take them with your healthcare provider. We strongly recommend against experimenting on your own with medications acquired illicitly.
There is some anecdotal support for using natural supplements to increase a person’s libido. Some of these supplements include:
Research is limited on these supplements, so it is unclear how effective they may be. And just because these supplements are natural, that doesn’t mean they are definitely safe to take. Talk to your clinician about ways they might affect you and how they may interact with your medications before taking any of them.
It is also important that you communicate with your partner about what you’re experiencing and why. Healthy communication with your partner can lead to an increased feeling of intimacy, which may relieve some of the pressure of worrying about your performance.
Don’t let worry about sexual side effects derail your recovery
Overall, sexual side effects of Suboxone may be effectively managed. You can find satisfaction in your personal life, while still continuing the life-saving medication-assisted treatment. No individual should need to sacrifice their quality of life or sexual satisfaction in order to achieve long-term recovery.