Does Heroin Affect Sex Drive

Clear Treatment

This article seeks to explain how heroin affects sex drive, sex life and sexual reproduction.


Human Sexuality

You have to read this. You won’t believe what’s coming next.

Sex is a critical part of a well-adjusted human being. That’s why it’s important to understand the full impact that heroin and other opiates have on human sexuality.


Will opiates harm your sex life?

sex-heroin-opiates-opioidsWe now know that drugs such as heroin, methadone, and oxycodone exert an inhibitory influence on sexual activity. Male users often have difficulty attaining or sustaining erections (erectile dysfunction). Though much of the evidence points to less arousal as opposed to actual impotence. Female opiate users typically have problems with vaginal moisture, and often skip menstrual cycles.

We also know that sexual side effects often lead to secondary psychological effects such as depression and anxiety. If sex changes from a pleasurable to a painful experience, it may inhibit development of new relationships.

What’s more…prepubertal opiate exposure tends to inhibit sexual maturation, especially in males. In other words, delayed onset of puberty, significantly smaller testes and sex-accessory glands (seminal vesicles, prostate, and bulbourethral glands).



In 1895 Reverend RH Graves1 noted how ‘opium ate out the virility of the individual’ and in 1925 Surgeon General HS Cumming2 stated ‘opium makes a man effeminate’. In 1839, Charles Bruce referred to the opium addicts in Assam as ‘more effeminate than women’.3


Sexual health studies

Scientific studies show that opiate use impairs sexual behavior, inhibits interest in having sex, depreciates the capacity to enjoy sex and diminishes the ability to start a family. Opiates have also been shown to produce disturbances in sexual need, sexual desire, sexual fantasy, erections, orgasms and fertility.

Scientific studies on male rats by M. Leyton and J. Stewart indicate that stimulation of kappa opioid receptors decreased male sexual behavior, locomotor activity, bodily grooming and body temperature. The study showed that male rats had a decrease in the average number of ejaculations, and longer dormancy periods between sexual activity.

Doctors Katz and Mazer wrote that long-term opioid therapy for either addiction or chronic pain often induces hypogonadism. Hypogonadism is a medical condition characterized by the body’s gonads producing little or no hormones. Opiate induced hypogonadism is owed primarily to suppression of hypothalamic secretion of gonadotropin-releasing hormone.

The National Center for Biotechnology Information (NCBI) wrote in 2010 that, “In humans and laboratory animals, opioids generally increase GH and prolactin and decrease LH, testosterone, estradiol, and oxytocin.” Later in that same report the NCBI wrote, “Increasing opioid abuse primarily leads to hypogonadism but may also affect the secretion of other pituitary hormones. The potential consequences of hypogonadism include decreased libido and erectile dysfunction in men, oligomenorrhea or amenorrhea in women, and bone loss or infertility in both sexes.”



It has been reported on many occasions that opioids, given by any route, suppress the hypothalamic–pituitary–gonadal axis and have a measurable impact on gonadal function.4

The hypothalamus is critically involved in coordinating sexual behavior, including drive, anticipation and function. In the medial pre-optic nucleus (MPON) of the hypothalamus, high dose opiate use inhibits male drive for and anticipation of sex. In the para-ventricular nucleus (PVN) region within the hypothalamus, high dose opiate use impairs penile erection. In the venture medial nucleus (VMN) of the hypothalamus, high dose opiate use inhibits female sex drive.


Pituitary Gland

As stated above, when opiates such as heroin bump into and activate opioid receptors in the hypothalamus brain region, they suppress hypothalamic function. High dose opiate use inhibits the release of Gonadatropin Releasing Hormone (GnRH) from the hypothalamus to the pituitary gland. Consequently, the pituitary gland cannot release leutenizing hormone (LH) and to a lessor extent follicle-stimulating hormone (FSH), into the bloodstream. Insufficient levels of LH in the bloodstream suppress testicular and ovarian function in both males and females.



Decreased gonadal function can lead to lower than normal hormone levels. Hormonal dysfunction may lead to a medical condition known as hypogonadism (gonadal atrophy). Hypogonadism occurs when the body’s gonads produce little or no hormones. Symptoms of opioid-induced hypogonadism include loss of libido, infertility, fatigue, depression, anxiety, loss of muscle strength and mass, osteoporosis, and compression fractures in both men and women; impotence in men; and menstrual irregularities and galactorrhea in women. Sex hormones help control sex characteristics, such as breast and testicle development, and pubic hair growth. They also play a role in menstrual cycles, sperm production and sex drive.


Sexual Side Effects of Hypogonadism:

One in depth scientific study showed that heroin misuse led to hypogonadism. The potential sexual side effects included loss of libido, infertility, fatigue, depression, anxiety, loss of muscle strength and mass, alteration of gender role, osteoporosis, and compression fractures and, in men, impotence, and, in females, menstrual irregularities, galactorrhea and infertility.

Long-term consequences of hypogonadism

When heroin users run out of heroin or quit using they tend to experience a reemergence of sexual function. However, the longer a person uses heroin and the older that heroin user is, the less sexual rebound occurs.

In Men

Loss of muscle mass and strength
Fractured DNA

In Women:

Oligomenorrhoea (irregular menses)
Amenorrhoea (no menses)

In both sexes:

Flushing and sweating
Loss of sex drive
Depression and anxiety
Low energy levels
Osteoporosis and fractures


Men on opiates

Male opiate users often joke about sex being “very low on the list” of important things to do. They may ask themselves, “Why can’t I get a hard-on?” The answer is simple. Male opiate users are not easily aroused. Even this guy down below is unlikely to take advantage of his situation.

Opiates affect the brain’s ability to produce precursor chemicals required to stimulate testicular production of testosterone (androgens), resulting in low testosterone, which adversely affects the male libido. Testosterone levels are consistently lower in opiate addicts as compared with control groups, and lower daily-dose users typically have higher testosterone levels than higher daily-dose users.

Men often have a difficult time getting hard on opiates. If and when they do get an erection, they’re likely to perform with less vigor (strength) and less vitality (life force). There’s also evidence suggesting that prolonged opiate use has harmful autoimmune effects on sperm production.

Opiates and sperm

Science has long understood that if a testicle is damaged to the point where sperm production is compromised, for whatever reason, it is unlikely to regain its sperm making abilities. In fact, many male long-term methadone users are found to be infertile.

Opiates and DNA

Deoxyribonucleic acid (DNA) is a molecule that carries the hereditary material in all known living organisms. The information in DNA is stored as a code made up of four chemical bases: adenine (A), guanine (G), cytosine (C), and thymine (T). Human DNA consists of about 3 billion of these bases, and more than 99 percent of those bases are the same in everyone. Current scientific evidence indicates that opiate use can fragment DNA within sperm. DNA fragmentation occurs when there is an alteration in the DNA strands. A high level of DNA fragmentation may cause male infertility leading to lower fertilization rates and/or miscarriage.

US Library of Medicine

TITLE: “The effects of opiate consumption on serum reproductive hormone levels, sperm parameters, seminal plasma antioxidant capacity and sperm DNA integrity.”
QUOTE: “A significant increase in the amount of fragmented DNA was found in opiate consumers compared with that in controls…”


Women on opiates

Female opiate users often experience fewer sexual thoughts, dreams, and fantasies. Women users may notice that their menses is not as on-schedule as it used to be. Opiates affect the female brain the same as men, but with different results, mainly because of the differences in male and female sexual reproductive systems. For females it’s typically missed periods and skipped ovulation.



Written by Kenneth John Nersten, CEO of Clear Detox Center, Inc. and Admissions Director of Clear Treatment.



1. Graves RH. Forty Years in China, Baltimore: Woodward, 1895.

2. Cumming HS, Control of Drug Addiction Mainly a Police Problem, The American City Magazine (November 1925)

3. Bruce CA. The manufacture of tea and on the extent and produce of tea plantations in Assam. Bishop’s College Press, 1839

4. Katz N, Mazer NA. The impact of opioids on the endocrine system. Clin J Pain 2009