Department of Social Work, Baradaran-e Rezaee Hospital, Semnan University of Medical Sciences, Damghan, Iran.
Arch Iran Med. 2012 Dec;15(12):751-5.
Sexual dysfunction (SD) is a common problem among chronic opiate dependents. The purpose of this study is to examine the prevalence of SD and to investigate whether there is a change in SD after six months of methadone maintenance treatment (MMT) compared with baseline.
We recruited 30 patients mean age 34.5 years from an MMT center in Damghan, Iran. Patients underwent structured interviews that consisted of the following: (i) socio-demographic characteristics, drug use, and sexual behavior ; (ii) the International Index of Erectile Function (IIEF-15) test for SD; (iii) the Zung test for depression; and (iv)analysis of serological status.
Overall, 8% of participants reported no SD, 69% reported mild to moderate SD, and 23% reported severe SD upon admission. After completion of the MMT program, these results decreased to 61% and 20%, respectively. In comparison with admission, the mean IIEF-15 score showed moderate improvement from 16.77 ± 7.08 to 21.8 ± 6.40 (P = 0.003). The mean IIEF-15 score for intercourse satisfaction completely improved from12.20 ± 4.55to 15 ± 3.76 (P = 0.001). Slight improvements were noted in the mean IIEF-15 score for sexual desire which increased from 5.10 ± 2.28 to 6.57 ± 2.12 (P = 0.017) and the mean IIEF-15 score for overall satisfaction which increased from 5.10 ± 2.29 to 6.58 ± 2.12 (P = 0.017). However, the mean IIEF-15 score for orgasmic function very slightly decreased from 4.73 ± 4.50 to 4.57 ± 1.92 (P = 0.191), which showed no statistically significant improvement after MMT. There was no relation with depression.
The findings of this study reveal a prevalence of SD and improvements in some aspects of SD in patients after six months of MMT. Patients should be screened for SD at the onset of opioid replacement treatment. Future studies on SD should examine the potential benefits of androgen replacement, hormone assay and the role of psychosocial factors.
性性功能障碍（SD）是慢性阿片类药物依赖者的常见问题。本研究的目的是调查 SD 的患病率，并研究与基线相比，经过六个月美沙酮维持治疗（MMT）后 SD 是否发生变化。
我们从伊朗达姆甘的一个 MMT 中心招募了 30 名平均年龄 34.5 岁的患者。患者接受了以下内容的结构化访谈：（i）社会人口统计学特征、药物使用和性行为；（ii）国际勃起功能指数（IIEF-15）测试 SD；（iii）Zung 测试抑郁；和（iv）血清状态分析。
总体而言，8%的参与者报告没有 SD，69%报告轻度至中度 SD，23%报告严重 SD。在完成 MMT 计划后，这些结果分别下降到 61%和 20%。与入院时相比，IIEF-15 评分的平均值从 16.77±7.08 提高到 21.8±6.40（P=0.003），显示出中度改善。性交满意度的 IIEF-15 评分平均值从 12.20±4.55 完全改善至 15±3.76（P=0.001）。性欲的 IIEF-15 评分平均值略有提高，从 5.10±2.28 增加到 6.57±2.12（P=0.017），整体满意度的 IIEF-15 评分平均值从 5.10±2.29 增加到 6.58±2.12（P=0.017）。然而，射精功能的 IIEF-15 评分平均值略有下降，从 4.73±4.50 降至 4.57±1.92（P=0.191），美沙酮治疗后无统计学意义上的改善。与抑郁无关。
本研究结果显示，在 MMT 六个月后，患者的 SD 患病率和某些方面的 SD 有所改善。在开始阿片类药物替代治疗时，应对患者进行 SD 筛查。未来关于 SD 的研究应检查雄激素替代、激素检测和心理社会因素的作用的潜在益处。
