The Impact of Buprenorphine Maintenance Therapy on Male Sexual Function in Opioid-Dependent Individuals: A Systematic Review and Meta-Analysis Publisher



Khalilzadeh M ; Dorooshi G ; Samsamshariat S ; Feizi A ; Bamarinejad A ; Nouri R ; Meamar R ; Eizadimood N
Source: Current Addiction Reports Published:2026

Abstract

Purpose of review: Sexual dysfunction (SD) is a common complication of opioid use disorder (OUD), and its treatment. Methadone maintenance therapy (MMT), as a cornerstone of OUD treatment, is frequently associated with SD. Buprenorphine maintenance therapy (BMT), due to its distinct pharmacology, may offer an alternative with a potentially lower risk of SD. This study aimed to synthesize the evidence on the effects of BMT on male sexual function in opioid-dependent individuals. Recent Findings: Following PRISMA guidelines, a systematic search was conducted in PubMed, ProQuest, Web of Science, Scopus, and the Cochrane Library. This review identified 12 eligible studies for qualitative synthesis, mostly comparing BMT and MMT. Pooled data from seven studies employing the International Index of Erectile Function (IIEF) demonstrated that, compared to MMT, BMT was associated with significantly better scores in erectile function (SMD = 0.360, p < 0.001), orgasmic function (SMD = 0.22, p = 0.046), sexual desire (SMD = 0.70, p < 0.001), and intercourse satisfaction (SMD = 0.41, p = 0.001). The total IIEF score was also significantly higher for BMT (SMD: 0.807, p < 0.0001). However, no significant difference was found in the overall satisfaction. Meta-regression indicated that most IIEF scores were independent of buprenorphine dose, methadone dose, or treatment duration. Summary: The current evidence indicates that BMT is superior to MMT in preserving male sexual function, particularly desire and erectile function. These findings support the consideration of BMT as a preferred maintenance treatment for patients prioritizing sexual health and underscore the importance of routine sexual health screening in clinical management. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026.