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Suboxone Sexual Side Effects in Males and Females

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Feb 20, 2024 • 12 cited sources

Suboxone contains buprenorphine, a partial opioid agonist. This medication works on the same receptors as other opioid drugs like Vicodin or heroin. And it can cause some of the same issues, including sexual side effects.

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The sexual side effects caused by Suboxone are mild when compared to those of full opioids. Yet nonetheless, they can be persistent and bothersome for some individuals.

Common side effects associated with Suboxone that we’ll explore in this article include the following:

  • Erectile dysfunction
  • Low testosterone
  • Difficulty with orgasm or libido

If sexual side effects are severe or troublesome, talk with your doctor. You may need a dose adjustment or different medication. 

How Common Are Sexual Side Effects?

Several studies have confirmed sexual dysfunction in men taking buprenorphine. In one study, about 83% of men taking buprenorphine and 90% taking naltrexone had at least one sexual dysfunction issue.[3]

In another study of women taking buprenorphine, 57% reported sexual dysfunction.[4]

While these studies suggest that sexual dysfunction may be a common side effect of opioid use, including Suboxone, they do not mean that an individual will or will not necessarily experience sexual dysfunction.

Why Does Suboxone/Buprenorphine Cause Sexual Dysfunction?

All opioids have been known to cause sexual dysfunction.[1] Medications used in OUD treatment (like methadone) and prescription painkillers can cause dysfunction. So can Suboxone, although oftentimes to a lesser extent than full opioids.

It is not known exactly how and why opioids cause sexual dysfunction. Suppression might play a role.

Opioids stimulate the μ-opioid receptor, suppressing the release of the sex hormones.[2] Blocking their production inhibits sexual function in both men and women and inhibits the release of the neurotransmitters needed to produce sexual desire.[2]

Sexual dysfunction can be caused by many things unrelated to OUD or its treatment, including hormonal imbalances, other medications, and medical, psychiatric or psychological problems.

Suboxone Sexual Side Effects in Males 

The prevalence of sexual dysfunction reported by men taking Suboxone for OUD treatment varies widely and ranges from 30% to 90%.[7]

A recent study followed a group of men with OUD from before starting buprenorphine to four months later. Results indicate that the sexual dysfunction scores were high initially and increased throughout the study, especially in sexual desire, psychological arousal, erection and ease of orgasm.[1] For some, these problems fade as they become accustomed to therapy.

These are a few problems men report:

Erectile Dysfunction (ED)

ED rates in buprenorphine patients have been reported to be as high as 77.5%. [6] However, it is not clear that this is due to the medication, or perhaps due to other factors that may be common to patients using Suboxone such as a history of opioid use itself, or other mental health or medical conditions. 

Low Testosterone Levels 

It is not known what effects buprenorphine has on sex hormones.[8] Some studies have shown that men taking buprenorphine have low testosterone levels, while others have found that people on buprenorphine have testosterone levels similar to healthy controls.

Suboxone Sexual Side Effects in Females 

Far fewer studies have been done on women taking buprenorphine products. As a result, we don’t know as much as we should about how this medication could change your sex life. But research suggests that women could face some issues. 

In one study, nearly 57% of women using medications like Suboxone for at least three months had some kind of sexual side effect.[4] Those problems include the following:

Difficulty With Orgasm/Libido  

It is not known whether a partial opioid agonist like buprenorphine can affect sexual function. Methadone might be associated with more difficulty achieving orgasm than buprenorphine.[9] But some women may report more difficulty with orgasm while on Suboxone. 

Can Suboxone Make You Infertile?

No, Suboxone is not known to affect fertility or one’s ability to get pregnant. If you are trying to become pregnant while on Suboxone, you should speak to your health care professional. But most clinicians would recommend continuing Suboxone therapy while trying to conceive, particularly if it prevents a relapse to opioid use, which could be even more dangerous for both mother and baby. 

What Can I Do if I Have Sexual Dysfunction While on Suboxone?

The first thing to do is talk to your medical provider and make sure that you have considered all the potential causes – Suboxone or others – that might be causing sexual dysfunction. Sexual dysfunction is often multifactorial and may be due to more than just Suboxone alone.

There are no therapies that show strong evidence for improving Sexual dysfunction in patients with OUD on either Methadone or Suboxone. Some medications (trazodone, bupropion) show some promise and might be used experimentally to treat some sexual side effects of Suboxone. [10]

Testosterone replacement for men or women with low blood testosterone levels might also restore sexual function and improve mood in certain cases. [11,4] However, testosterone therapy has some significant risks and it is unclear whether the benefits would outweigh those risks. At this time, most clinicians would NOT recommend testosterone therapy for patients with sexual dysfunction on Suboxone.

Is It Safe to Take Viagra & Suboxone?

There are no known interactions between Suboxone and Viagra or any other erectile dysfunction (ED) treatments.[12] However, it’s always important to talk with your healthcare provider before taking any medicines for ED, as some can have serious side effects, especially if you have certain medical conditions.

Should You Start Treatment With Suboxone?

If you experience sexual dysfunction while taking Suboxone, get a medical workup from your healthcare provider. You may decide that the side effects or risks are worth the benefits of treatment.

Learn About FDA-Approved OUD Treatment Options from Bicycle Health

Bicycle Health uses Suboxone as a primary medication for dealing with opioid dependence. To learn more about the benefits and the effects of Suboxone, schedule a time to speak with one of our MAT professionals, or call us today at (844) 943-2514.

Photo by Toa Heftiba on Unsplash

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. The Effects of Buprenorphine/Naloxone Maintenance Treatment on Sexual Dysfunction, Sleep, and Weight in Opioid Use Disorder Patients. Psychiatry Research. February 2019. Accessed September 2022.
  2. Plasma Testosterone and Sexual Function in Southeast Asian Men Receiving Methadone and Buprenorphine Maintenance Treatment. The Journal of Sexual Medicine. February 2018. Accessed September 2022.
  3. Sexual Dysfunction Among Male Patients Receiving Buprenorphine and Naltrexone Maintenance Therapy for Opioid Dependence. Journal of Sexual Medicine. December 2012. Accessed September 2022.
  4. Sexual Functioning and Opioid Maintenance Treatment in Women. Results From a Large Multicentre Study. Frontiers. May 2019. Accessed September 2022.
  5. The Prevalence of Sexual Dysfunction Among Male Patients on Methadone and Buprenorphine Treatments: A Meta-Analysis Study. The Journal of Sexual Medicine. January 2014. Accessed September 2022.
  6. Sexual Dysfunction in Men on Buprenorphine: Naloxone-Based Substitution Therapy. Indian Journal of Psychiatry. January 2020. Accessed September 2022.
  7. Sexual Adverse Effects and Erectile Dysfunction During Buprenorphine/Naloxone Combination Treatment for Opioid Use Disorders. Neuropsychiatric Disease and Treatment. November 2020. Accessed September 2022.
  8. Impact of Opioid Therapy on Gonadal Hormones: Focus on Buprenorphine. Hormone Molecular Biology and Clinical Investigation. February 2018. Accessed September 2022.
  9. Buprenorphine and Methadone Maintenance Treatment – Sexual Behaviour and Dysfunction Prevalence. Letters in Drug Design and Recovery. November 2009. Accessed September 2022.
  10. Treatments of Sexual Dysfunction in Opioid Substitution Therapy Patients: A Systematic Review and Meta-Analysis. International Journal of Medical Sciences. 2021. Accessed September 2022.
  11. Opioid-Induced Sexual Dysfunction. Practical Pain Management. December 2011. Accessed September 2022. 
  12. Which Drug for Erectile Dysfunction? Harvard Medical School. August 2022. Accessed September 2022.

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