Reichmann Geetika, Parlier-Ahmad Anna Beth, Beck Lori, Thakkar Bhushan, Alappattu Meryl, Boissoneault Jeff, Martin Caitlin E
School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.
Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States.
Front Pain Res (Lausanne). 2022 Jan 11;2:787559. doi: 10.3389/fpain.2021.787559. eCollection 2021.
Chronic pain brings complexity to opioid use disorder (OUD). Psychosocial and neurobiological risks for Chronic Pelvic Pain (CPP) and OUD overlap. The primary objective of this exploratory study is to compare sex-specific prevalence of CPP and sexual dysfunction between individuals receiving buprenorphine for OUD and a comparison group receiving treatment for other chronic medical conditions (CMC). Participants from an OUD treatment ( = 154) and primary care clinic ( = 109) completed a survey between July 2019 and February 2020 assessing reproductive and sexual health. Sexstratified CPP and pain interference measures were adapted from the Brief Pain Inventory for females, and for males, the Brief Male Sexual Function Inventory and NIH Chronic Prostatitis Symptom Index. The Male and Female Sexual Function Index assessed sexual dysfunction. Prevalence of CPP and sexual dysfunction between groups were compared using Pearson χ2 and Fisher's Exact tests. Participants were 54.4% female and 75.0% Black with almost half having a psychiatric diagnosis. Among OUD females, the highest pain severity reported was for menstrual-related pain, and for OUD males, testicular pain. CPP most interfered with mood in OUD females vs. sleep and enjoyment of life in OUD males. There were no differences in prevalence for global sexual dysfunction with 91.6% of females and 84.2% of males screening positive across groups. CPP and sexual dysfunction are important components of wellness and may play a role in OUD recovery trajectories. The value of addressing CPP and sexual dysfunction in tailored comprehensive, sex-informed OUD treatment approaches should be further investigated.
慢性疼痛给阿片类物质使用障碍（OUD）带来了复杂性。慢性盆腔疼痛（CPP）和OUD的心理社会及神经生物学风险存在重叠。这项探索性研究的主要目的是比较接受丁丙诺啡治疗OUD的个体与接受其他慢性疾病（CMC）治疗的对照组之间CPP的性别特异性患病率及性功能障碍情况。来自一个OUD治疗机构（n = 154）和一家初级保健诊所（n = 109）的参与者在2019年7月至2020年2月期间完成了一项评估生殖和性健康的调查。针对女性，CPP和疼痛干扰测量指标改编自简明疼痛问卷；针对男性，则改编自简明男性性功能问卷和美国国立卫生研究院慢性前列腺炎症状指数。男性和女性性功能指数用于评估性功能障碍。使用Pearson χ2检验和Fisher精确检验比较两组之间CPP和性功能障碍的患病率。参与者中54.4%为女性，75.0%为黑人，近一半人有精神疾病诊断。在患有OUD的女性中，报告的最高疼痛严重程度是与月经相关的疼痛，而在患有OUD的男性中是睾丸疼痛。在患有OUD的女性中，CPP对情绪的干扰最大，而在患有OUD的男性中则是对睡眠和生活乐趣的干扰最大。两组间总体性功能障碍的患病率没有差异，91.6%的女性和84.2%的男性筛查呈阳性。CPP和性功能障碍是健康的重要组成部分，可能在OUD的康复轨迹中发挥作用。在针对OUD的量身定制的全面、性别知情治疗方法中解决CPP和性功能障碍的价值应进一步研究。
