Department of Oncology.
National Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Pain Med. 2019 Jun 1;20(6):1132-1140. doi: 10.1093/pm/pny122.
Associations between chronic pain, opioid use, and sexual problems are acknowledged, but population-based investigations are sparse. Our study aimed at investigating the associations between chronic noncancer pain (CNCP), opioid use, lack of/low sexual desire, and dissatisfaction with sexual life.
In 2013, 11,517 randomly selected individuals of the Danish population (18-74 years old without cancer) completed a self-administered questionnaire.
We classified CNCP: pain lasting six months or longer, short-term opioid use: one or more prescriptions the previous year, long-term opioid use: one or more prescriptions per month for six months the previous year. Sexual problems were assessed by four closed-ended questions. Data on dispensed opioids were retrieved from the Danish National Prescription Registry. Multiple logistic regression analysis was used to examine associations between CNCP, opioid use, and lack of/low sexual desire, and dissatisfaction in sexual life, presented as odds ratios (95% confidence intervals [CIs]).
Compared with individuals without CNCP, individuals with CNCP in the long-term and short-term opioid use group and in the nonopioid use group were more likely to report a lack of/low sexual desire (OR = 2.64, 95% CI = 1.80-3.88; OR = 1.82, 95% CI = 1.39-2.38; OR = 1.46, 95% CI = 1.28-1.67, respectively) and dissatisfaction with sex life (OR = 1.69, 95% CI = 1.07-2.67; OR = 1.35, 95% CI = 1.00-1.82; OR = 1.38, 95% CI = 1.22-1.58, respectively). Compared with CNCP patients not using opioids, long-term opioid users with CNCP had statistically significant higher odds of reporting a lack of/low sexual desire (OR = 1.81, 95% CI = 1.23-2.68).
Long-term opioid therapy for CNCP requires special attention due to its potential in suppressing sexual desire.
慢性疼痛、阿片类药物使用与性功能障碍之间存在关联,这一点已得到公认,但基于人群的调查研究却相对较少。本研究旨在调查慢性非癌痛(CNCP)、阿片类药物使用、性欲缺乏/低下以及对性生活不满之间的关联。
2013 年,丹麦人群中随机选择了 11517 名(18-74 岁,无癌症)个体完成了一份自我管理问卷。
我们将 CNCP 定义为:持续时间为六个月或更长时间的疼痛;短期阿片类药物使用:前一年有一个或多个处方;长期阿片类药物使用:前一年每月有一个或多个处方。性功能障碍通过四个封闭式问题进行评估。从丹麦国家处方登记处获取有关阿片类药物的处方数据。使用多变量逻辑回归分析检查 CNCP、阿片类药物使用与性欲缺乏/低下以及对性生活不满之间的关联,结果表示为比值比(95%置信区间[CI])。
与无 CNCP 的个体相比,长期和短期阿片类药物使用组以及非阿片类药物使用组中患有 CNCP 的个体更有可能报告性欲缺乏/低下(OR=2.64,95%CI=1.80-3.88;OR=1.82,95%CI=1.39-2.38;OR=1.46,95%CI=1.28-1.67)和对性生活不满(OR=1.69,95%CI=1.07-2.67;OR=1.35,95%CI=1.00-1.82;OR=1.38,95%CI=1.22-1.58)。与未使用阿片类药物的 CNCP 患者相比,患有 CNCP 的长期阿片类药物使用者报告性欲缺乏/低下的可能性明显更高(OR=1.81,95%CI=1.23-2.68)。
针对 CNCP 的长期阿片类药物治疗需要特别注意,因为其可能会抑制性欲。