title: Premature ejaculation and other sexual dysfunctions in opiate dependent men receiving methadone substitution treatment.
abstract: BACKGROUND
  A significant number of men with opiate misuse have sexual problems. Premature ejaculation (PE) occurs predominantly on discontinuation of the opiate but seems to persist in some cases. The aims of this study were to determine the rates of PE and other sexual dysfunctions in patients maintained on methadone; to determine the time of onset of PE in relation to onset of opiate misuse; and to look at the patients' perception of the effect of heroin and methadone on PE.
  
  
  METHODS
  Sixty five men attending a tertiary referral clinic for methadone maintenance treatment were assessed cross-sectionally using a semi-structured questionnaire, clinical interview, review of clinical records and the International Index of Erectile Function (IIEF).
  
  
  RESULTS
  Thirty eight (58.5%) subjects reported a "lifetime" history of PE. Twenty (30.76%) of them reported "current" history of PE. Eleven (16.9%) people reported that PE preceded opiate misuse. Twenty four (63.2%) felt that heroin helped their PE and 7 (18.4%) felt that heroin worsened it. Fourteen (36.8%) felt that methadone helped PE, while 10 (26.3%) felt methadone worsened PE. Only 2 out of 65 (3.07%) reported that they had been asked about their sex life by the addiction services.
  
  
  CONCLUSIONS
  Prevalence of "current" premature ejaculation was almost 3 times greater than reported in the general population. A significant number of patients perceived heroin to be beneficial on PE. Presence of sexual dysfunction could therefore be a risk factor for relapse into heroin misuse. Most clinicians avoid asking patients questions of a sexual nature. Nevertheless, managing sexual difficulties among patients with opiate misuse could be a significant step in relapse prevention.
authors.affiliation: General Adult Psychiatry, Parkhead Hospital, Glasgow G315EB, United Kingdom. vchekuri@nhs.net
authors.forename: Venkat
authors.initials: V
authors.lastname: Chekuri
authors.forename: David
authors.initials: D
authors.lastname: Gerber
authors.forename: Adam
authors.initials: A
authors.lastname: Brodie
authors.forename: Rajeev
authors.initials: R
authors.lastname: Krishnadas
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004542:Ejaculation; D003932:Heroin / Q000009:adverse effects*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D011159:Population Surveillance; D015995:Prevalence; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced / Q000453:epidemiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D003932:Heroin; D008691:Methadone