Though it still has an effect, buprenorphine (Suboxone) has been shown to have a lesser effect on testosterone levels than methadone.
Does Suboxone Have an Effect on Testosterone?
Suboxone (buprenorphine/naloxone) can have an effect on serum levels of testosterone in men. However, the clinical effects of this are unclear and don’t necessarily mean that there will be any changes in sexual function, hair growth, mood, or strength.
Some men do occasionally report sexual dysfunction on Suboxone. However, this is less common in patients who have been on opioids prior. Compared to methadone and other full opioid agonist medications, sexual side effects are less common with Suboxone.
If you experience sexual changes on Suboxone, discuss them with your provider.
How Often Does Suboxone Affect Testosterone Levels?
There is limited data on the frequency with which Suboxone affects testosterone levels, but it is accepted that it can influence them. While further research is needed, it is known that buprenorphine has a lesser effect on testosterone levels than methadone. However, just because the testosterone number changes does not mean the patient will experience any of these negative consequences. In general, when this has been studied, men do not tend to experience changes in sexual function, hair growth, mood, exercise tolerance or strength. What matters is how the patient feels, not the testosterone level itself.
Can Suboxone Cause Infertility in Males?
No, Suboxone does not cause infertility in males.  If you are on Suboxone, talk to your doctor about any fertility concerns you have.
- Plasma Testosterone and Sexual Function in Men Receiving Buprenorphine Maintenance for Opioid Dependence. The Journal of Clinical Endocrinology and Metabolism. https://pubmed.ncbi.nlm.nih.gov/15483091/. January 2005. Accessed April 2022.
- Hypogonadism and Low Testosterone Levels as a Side Effect of Methadone and Buprenorphine. International Journal of High-Risk Behaviors & Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070102/. Summer 2012. Accessed April 2022.
- Testosterone Deficiency. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2749876. September 2019. Accessed April 2022.
- Testosterone Suppression in Opioid Users: A Systematic Review and Meta-Analysis. Drug and Alcohol Dependence. https://www.sciencedirect.com/science/article/pii/S0376871615000733. April 2015. Accessed April 2022.
- Chronic Exposures and Male Fertility: The Impacts of Environment, Diet, and Drug Use on Spermatogenesis. Andrology. https://onlinelibrary.wiley.com/doi/full/10.1111/andr.12198. May 2016. Accessed April 2022.
By: Elena Hill, MD, MPH
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