Plasma Testosterone and Sexual Function in Southeast Asian Men Receiving Methadone and Buprenorphine Maintenance Treatment

Background: Methadone has been recognized as an effective maintenance treatment for opioid dependence. However, its use is associated with several complications, including sexual dysfunction in men. Aim: To assess plasma testosterone and sexual function in Southeast Asian men on methadone maintenance treatment (MMT) or buprenorphine maintenance treatment (BMT). Methods: 76 sexually active men on MMT (mean age = 43.30 +/- 10.32 years) and 31 men on BMT (mean age = 41.87 +/- 9.76 years) from a Southeast Asian community were evaluated using plasma total testosterone (TT) and prolactin levels, body mass index, social demographics, substance use measures, and depression severity scale. Outcomes: Prevalence and associated factors of TT level lower than the reference range in men on MMT or BMT. Results: More than 1 third of men (40.8%, n = 31) on MMT had TT levels lower than the reference range, whereas 1 fourth of men (22.6%, n = 7) onBMTdid. At univariate analysis, MMTvsBMT(beta = 0.298, adjusted R-2 = 0.08, P =.02) and body mass index (beta = -0.23, adjusted R-2 = 0.12, P =.02) were associated with changes in TT after stepwise regression. There were no significant associations with age; Opiate Treatment Index Q scores for alcohol, heroin, stimulant, tobacco, or cannabis use and social functioning domain; education levels; hepatitis C status; and severity of depression. Prolactin level did not differ between the MMT and BMT groups. Clinical Implications: The sex hormonal assay should be used regularly to check men on MMT. Strengths and Limitations: This is the first study conducted in the Southeast Asian community. Our study was limited by the lack of a healthy group as the reference for serum levels of testosterone and prolactin. Conclusions: The findings showed that plasma testosterone levels are lower in MMT than in BMT users. Hence, men who are receiving MMT should be screened for hypogonadism routinely in the clinical setting. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.