
Does testosterone come back after opioid use?
Testosterone levels begin to recover within days after you stop using heroin. Heroin-dependent men see significant improvement within 1–3 months of sustained abstinence, but long-term heroin use may cause more lasting hormonal disruption requiring longer recovery periods. Your age, overall health, and history of drug use all affect how quickly your body restores normal testosterone production.
Some people, particularly those with five or more years of heroin dependence, might need medical intervention to restore hormone balance. Laboratory investigations can determine if your testosterone levels require additional treatment beyond abstinence from opioids.
Can painkillers affect libido?
Prescription painkillers containing opioids impact sexual desire through their pharmacological effects on hormone regulation. These drugs of abuse disrupt the same hormone pathways as heroin, reducing testosterone in men and altering estrogen cycles in women. Even short-term use of prescription opioids can diminish sexual arousal and satisfaction.
The stronger the painkiller and the longer you use it, the more pronounced these sexual side effects become. Painkillers also affect psychological aspects of sexuality by dulling emotional responses and creating psychological distress that further reduces interest in sexual intimacy.
Does codeine cause low libido?
Codeine can reduce sexual desire, but less severely than heroin or oxycodone. As a mild opioid, codeine affects the same hormone systems that regulate sexual function, and may decrease libido, cause erectile dysfunction in males, and reduce sexual satisfaction. The risk factors increase with higher doses and regular use. Even over-the-counter codeine products used long-term impacted sexual arousal.
If you notice sexual side effects while taking codeine-containing medications, discuss this with your healthcare provider. They will give you alternative medication options with fewer sexual side effects.
What are the side effects of opioids?
Opioids cause many side effects beyond decreased libido that impact virtually every body system. Common immediate effects include:
- Severe constipation and digestive problems.
- Nausea and vomiting.
- Extreme drowsiness and sedation.
- Dangerous respiratory depression.
- Itching and skin reactions.
Long-term physical effects include:
- Blood vessel damage and cardiovascular problems.
- Compromised immune function.
- Disrupted hormone production.
- Impaired liver function.
- Sleep disturbances.
Users also experience a wide range of mental and psychological effects, such as:
- Depression and anxiety.
- Cognitive impairment and memory problems.
- Increased pain sensitivity over time.
- Social isolation and relationship breakdown.
The most dangerous side effect is an overdose, which can quickly become fatal without immediate medical intervention.
Resources
Llanes C, Álvarez AI, Pastor MT, Garzón MÁ, González-García N, Montejo ÁL. Sexual Dysfunction and Quality of Life in Chronic Heroin-Dependent Individuals on Methadone Maintenance Treatment. J Clin Med. 2019 Mar 7;8(3):321. doi: 10.3390/jcm8030321. PMID: 30866482; PMCID: PMC6463066.
Laélia Briand Madrid, Stéphane Morel, Khadim Ndiaye, Salim Mezaache, Daniela Rojas Castro, Marion Mora, Fabrice Olivet, Virginie Laporte, Camelia Protopopescu, Patrizia Carrieri, Perrine Roux, Factors associated with perceived loss of libido in people who inject opioids: Results from a community-based survey in France, Drug and Alcohol Dependence, Volume 190, 2018, Pages 121-127, ISSN 0376-8716, https://doi.org/10.1016/j.drugalcdep.2018.05.030.
Zhang M, Zhang H, Shi CX, McGoogan JM, Zhang B, Zhao L, Zhang M, Rou K, Wu Z. Sexual dysfunction improved in heroin-dependent men after methadone maintenance treatment in Tianjin, China. PLoS One. 2014 Feb 10;9(2):e88289. doi: 10.1371/journal.pone.0088289. PMID: 24520361; PMCID: PMC3919724.
Further reading
How does heroin affect the brain?
When do levels of testosterone improve after stopping drinking?
Can erectile function improve if I stop drinking?
Does sexual experience improve after you quit alcohol?
What is substance use disorder (SUD)?